NCT04878887

DRA vs PRA for US-guided Radial Artery Catheterization in ICU

Comparaison Between Ultrasound-guided Distal and Proximal Approaches for Radial Artery Catheterization in Intensive Care Unit

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 94 (actual)
• Sponsor: University Tunis El Manar · Academic / Other
• Sex: All
• Age: 15 Years – 90 Years
• Healthy volunteers: Not accepted

Summary

Patients were randomly divided into two groups: ultrasound-guided (US-guided) in-plane distal radial access (IP-DRA) and in-plane proximal radial access (IP-PRA) catheterization. For IP-DRA , a linear transducer is placed in the radial fossa, which is known as the snuff-box. After obtaining a long-axis view of the radial artery ,the needle is inserted in the midpoint of the small footprint transducer. Then,the needle is advanced under real-time US guidance until visualizing the tip of the needle inside the artery . For IP-PRA , a linear transducer is placed in the standard conventional forearm radial. After obtaining a long-axis view of the radial artery ,the needle is inserted in the midpoint of the small footprint transducer. Then,the needle is advanced under real-time US guidance until visualizing the tip of the needle inside the artery .

Detailed description

\*Ultrasound-guided catheterization of the radial artery, by proximal approach: * Patient's hand in hyperextension with slight dorsiflexion of the wrist. * The placement of the ultrasound probe initially linear in order to obtain the "short axis" image of the artery; then a quarter turn until obtaining a longitudinal "long axis" view. * The operator must identify the artery using the pulsed wave Doppler; * Insertion of the needle in the middle of the transducer providing an "in plane" orientation. Thus the needle was advanced slowly and its tip was visualized throughout the procedure. \*Ultrasound-guided catheterization of the radial artery, by distal approach: * If the right hand is along the body / if the left hand is on the trunk. * The ultrasound probe placed at the level of the anatomical snuffbox by placing the transducer in a linear fashion then rotated coronally until a longitudinal image is obtained \*In the 2 groups: - The longitudinal "in plane" approach is used - After visualization of the penetration of the bevel of the needle into the lumen of the artery and the jet of arterial blood into the syringe on aspiration, a flexible metal guide was introduced into the artery through the trocar according to the Seldinger's method. - The correct positioning of the guide in the artery was then confirmed by ultrasound. Any obstacle preventing insertion of the guide system always led to a new puncture.

Conditions

• Ultrasonography

Interventions

Type	Name	Description
PROCEDURE	IP-DRA vs IP- PRA	Catetherization approach in plane : distal radial artery VS proximal radial artery

Timeline

• Start date: 2021-03-26
• Primary completion: 2022-10-20
• Completion: 2022-12-15
• First posted: 2021-05-10
• Last updated: 2023-06-06

Locations

1 site across 1 country: Tunisia