Biplanar versus conventional two-dimensional ultrasound guidance for radial artery catheterisation
Harm J. Scholten,
Gwen Broens,
Michael I. Meesters,
Joris van Houte,
Renee J.C. van den Broek,
Leontien ter Horst,
Danihel van Neerven,
Marjolein Hoefeijzers,
Veerle Piot,
Leon J. Montenij,
Erik H.M. Korsten,
R. Arthur Bouwman
Affiliations
Harm J. Scholten
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands; Corresponding author. Department of Anaesthesiology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Gwen Broens
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Anaesthesiology, Maastricht University Medical Centre, Maastricht, The Netherlands
Michael I. Meesters
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Joris van Houte
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Renee J.C. van den Broek
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Leontien ter Horst
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Danihel van Neerven
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Anaesthesiology, Maastricht University Medical Centre, Maastricht, The Netherlands
Marjolein Hoefeijzers
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Veerle Piot
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Leon J. Montenij
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
Erik H.M. Korsten
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
R. Arthur Bouwman
Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
Background: Ultrasound guidance increases first-pass success rates and decreases the number of cannulation attempts and complications during radial artery catheterisation but it is debatable whether short-, long-, or oblique-axis imaging is superior for obtaining access. Three-dimensional (3D) biplanar ultrasound combines both short- and long-axis views with their respective benefits. This study aimed to determine whether biplanar imaging would improve the accuracy of radial artery catheterisation compared with conventional 2D imaging. Methods: This before-and-after trial included adult patients who required radial artery catheterisation for elective cardiothoracic surgery. The participating anaesthesiologists were experienced in 2D and biplanar ultrasound-guided vascular access. The primary endpoint was successful catheterisation in one skin break without withdrawals. Secondary endpoints were the numbers of punctures and withdrawals, scanning and procedure times, needle visibility, perceived mental effort of the operator, and posterior wall puncture or other mechanical complications. Results: From November 2021 until April 2022, 158 patients were included and analysed (2D=75, biplanar=83), with two failures to catheterise in each group. First-pass success without needle redirections was 58.7% in the 2D group and 60.2% in the biplanar group (difference=1.6%; 95% confidence interval [CI], –14.0%–17.1%; P=0.84), and first-pass success within one skin break was 77.3% in the 2D group vs 81.9% in the biplanar group (difference=4.6%; 95% CI, 8.1%–17.3%; P=0.473). None of the secondary endpoints differed significantly. Conclusions: Biplanar ultrasound guidance did not improve success rates nor other performance measures of radial artery catheterisation. The additional visual information acquired with biplanar imaging did not offer any benefit. Clinical trial registration: N9687 (Dutch Trial Register).
