Wednesday April 19, 2006
Ultrasound guided insertion of radial artery catheters
Role of ultrasound guidance in central venous catheter (particularly internal jugular vessel) is well known 1 but literature on its efficacy in arterial line insertion is very scant. Levin and coll. from Hadassah University Hospital, Jerusalem, Israel has done a simple but interesting study on the use of ultrasound guidance in the insertion of radial artery catheters 2. A total of 69 patients were randomized - 34 to the ultrasound group and 35 to the palpation group. The following results were found:
* The arterial cannula was inserted on the first attempt in 21 of the 34 patients (62%) in the ultrasound group vs. 12 of the 35 patients (34%) in the palpation group.
* Overall, there were 55 total attempts (1.6 per patient) at arterial catheter insertion in the ultrasound group vs. 110 (3.1 per patient) in the palpation group.
* The mean overall time taken per patient for catheter insertion was 55.5 secs in the ultrasound group vs. 111.5 secs in the palpation group.
* In the ultrasound group, a total of 39 cannulae were used vs. 60 in the palpation group (cost effectiveness).
1 Bedside Ultrasonography in the ICU Part 2 - Chest. 2005;128:1766-1781
2. Use of ultrasound guidance in the insertion of radial artery catheters - Critical Care Medicine: Volume 31(2) February 2003 pp 481-484