COMPARISON OF TWO METHODS OF RADIAL ARTERIAL CATHETERIZATION: THE PALPATORY METHOD VERSUS ULTRASOUND GUIDANCE

Abstract

Anatomical landmarks and palpation are traditionally used for radial arterial catheterization in emergency units. Despite the successful use of ultrasound monitoring for central venous access, there is a lack of evidence about the benefits of the ultrasound guidance for peripheral arterial cannulation.The objective: to compare two methods of radial arterial catheterization (the traditional one based on palpation and the method under ultrasound guidance) in the patients undergoing planned surgery.Subjects and methods. 40 patients participated in the prospective cohort study, all of them had planned surgeries. In Group 1, the traditional method was used for arterial catheterization (the palpation group), and in Group 2 it was done under ultrasound guidance (the ultrasound group). The following parameters were recorded for both groups: number of attempts, number of puncture sites, complications and their type, time of catheterization. The number of cannulation attempts was taken as a primary endpoint.Results. The statistically significant correlation was found between the method of catheterization and the number of attempts (Pearson's chi-squared test = 29.562, df = 6, p < 0.001), places of puncture (Pearson's chi-squared test = 10.365, df = 3, p = 0.015). In the ultrasound group, the first attempt of cannulation was a success in 19 cases (95%; CI 73−99%), while in the palpation group, the first attempt was a success in 2 cases (10%; CI 2−33%). The one catheterization site was used in 95% of cases in the ultrasound group (CI 73−99%; 1 observation). While in Group 2 (the palpation group), two sites of cannulation and more were required in 50% of patients (CI 30−17%; 10 observations). Among complications there were hematomas, and no statistically significant correlations were found between the method of puncture and their number in the groups (Pearson's chi-squared test = 2.7706, df = 1, p = 0.09601). The time spent on catheterization in the ultrasound group was shorter versus the palpation group (W = 344, p < 0.001) and it made 101 sec. (51; 144) and 194 sec. (153; 311) respectively.Conclusion: Compared to the traditional (palpation) method, the radial arterial catheterization guided by ultrasound possesses such benefits as high chances of successful cannulation with the first attempt, fewer sites required to provide arterial access and total time required for the manipulation.

Keywords

• catheterization
• radial artery
• ultrasound monitoring