Scale Ultrasound-guided Radial Artery Cannulation in infant: A Randomized Controlled Trial

Abstract BackgroundCannulation of the radial artery can be extremely challenging in infants. Scale ultrasound can provide accurate arterial location and guidance for operators. We hypothesized that scale ultrasound helps increase the initial success rate of radial artery cannulation in this population.MethodThis is a double-blinded, parallel-group trial prospective study. Seventy-six infants aged 0–3 months who needed arterial puncture after general anesthesia were randomly divided into two groups (1:1 ratio): the scale ultrasound group and the traditional ultrasound group. Patients in the traditional ultrasound group underwent conventional ultrasound-guided radial artery puncture, whereas radial artery puncture was guided by scale ultrasound in the scale ultrasound group. The primary endpoints were the success rate of the first attempt and the total success rate of arterial cannulation. The secondary endpoints were the time of ultrasound location, the time of the needle entering the radial artery, the time of successful cannulation, times of the arterial puncture and the incidence of vascular complications. Data analysis was performed with Minitab 18.0 (Minitab Inc., USA).Main ResultsThe success rate of the first attempt and the total success rate of arterial cannulation were 92.1% (35/38) and 100% (38/38) in the scale ultrasound group and 50% (19/38) and 86.8% (33/38) in the traditional ultrasound group (p < 0.005), respectively. The median time to ultrasound location, needle entry into the radial artery and successful cannulation in the scale ultrasound group were significantly shorter than those in the traditional ultrasound group: 10 (8.0, 17.2) s, 15 (11.7, 20) s and 65 (53.8, 78.5) s vs 30 (26.5, 43.5) s, 35 (23, 51) s and 224.5 (123.5, 356) s (p < 0.001), respectively. The incidence of hematoma was higher in the traditional group (p < 0.005).ConclusionsScale ultrasound-guided radial arterial cannulation can significantly improved initial success rate and overall success rate, shorten puncture time in infant,compared with that achieved with the use of traditional ultrasound guidance.