An interventional study of Ultrasound-guided Radial Artery Catheter Insertion and Direct Palpation-guided Radial Artery Catheter insertion in Time to Insertion of Radial Artery Cannulation, sponsored by University of British Columbia. Completed at 1 site in Canada. Open to participants aged 19 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2015-05-07.
Sponsored by University of British Columbia · Not applicable, Interventional, and Prevention
When a patient undergoes heart surgery, their Anesthesiologist will insert a tiny plastic tube, called a catheter, in the artery of the patient's wrist. This is called a radial artery catheter. A radial artery catheter allows accurate measurement of the patient's blood pressure during surgery. There are two common techniques for placing the radial artery catheter. The first is a "blind" technique whereby the Anesthesiologist feels for the pulse in the patient's wrist and places the catheter using the location of the pulse as a guide. The second technique, less commonly used, is one whereby the Anesthesiologist uses an ultrasound machine (painless to the patient) to "see" the artery, and thereby uses the ultrasound to guide the catheter placement. Our study will test the hypothesis that ultrasound-guided radial artery catheterization will have faster insertion times, with fewer complications compared with palpation-guided insertion.
University of British Columbia is the lead sponsor of 1,309 studies on the registry; 253 are open to participants now.
Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Radial artery catheter insertion will be conducted by direct palpation and use of anatomic knowledge by the Anesthesiologist.
Device: Direct Palpation-guided Radial Artery Catheter insertion
Radial artery catheter insertion will be conducted by ultrasound guidance. A Sono-site ilook 25 Ultrasound (Sono-site, Inc., Bothell, WA, USA) with a 10-5 MHz linear array ultrasound transducer will be used. At the discretion on the Anesthesiologist, an out-of-plane (i.e. needle plane at right angles to ultrasound plane) will be used. Colour flow doppler may also be used to identify the artery if necessary.
Device: Ultrasound-guided Radial Artery Catheter Insertion
Time to Successful Radial Arterial Catheterization
The time to successful radial arterial catheterization was defined as time zero to time of placement. Time zero for the DP group began when the anesthesiologist's fingers were placed on the patient with the purpose of palpating the artery. Time zero for the US group began when the US transducer was first placed on the patient's skin for the purpose of identifying the radial artery. Time to placement was defined as the interval from time zero until the time at which an arterial tracing was viewed on the monitor.
Time frame: up to 5 minutes
Number of Attempts
An attempt was defined as a new purposeful penetration of the skin with the needle (i.e., following complete withdrawal of the needle from the skin).
Time frame: up to 5 minutes
Number of Re-directions
A re-direct was defined as the needle being purposefully withdrawn at least 5 mm and re-directed (but not removed from the skin entirely).
Time frame: up to 5 minutes
Complication Rate (Hematoma)
A hematoma was defined a collection of blood or formation of a bruise surrounding the site of radial artery catheterization
Time frame: up to 5 minutes
| Milestone | Direct Palpation | Ultrasound |
|---|---|---|
| Started | 65 | 64 |
| Completed | 62 | 63 |
| Not completed | 3 | 1 |
The time to successful radial arterial catheterization was defined as time zero to time of placement. Time zero for the DP group began when the anesthesiologist's fingers were placed on the patient with the purpose of palpating the artery. Time zero for the US group began when the US transducer was first placed on the patient's skin for the purpose of identifying the radial artery. Time to placement was defined as the interval from time zero until the time at which an arterial tracing was viewed on the monitor.
| seconds | Direct Palpation | Ultrasound |
|---|---|---|
| Time to Successful Radial Arterial Catheterization | 104 (76 to 212) | 104 (68 to 270) |
An attempt was defined as a new purposeful penetration of the skin with the needle (i.e., following complete withdrawal of the needle from the skin).
| number of attempts | Direct Palpation | Ultrasound |
|---|---|---|
| Number of Attempts | 1 (1 to 2) | 1 (1 to 2) |
A re-direct was defined as the needle being purposefully withdrawn at least 5 mm and re-directed (but not removed from the skin entirely).
| number of re-directs | Direct Palpation | Ultrasound |
|---|---|---|
| Number of Re-directions | 2 (0 to 6) | 3 (1 to 5) |
A hematoma was defined a collection of blood or formation of a bruise surrounding the site of radial artery catheterization
| percentage of participants | Direct Palpation | Ultrasound |
|---|---|---|
| Complication Rate (Hematoma) | 22.6 | 11.1 |
Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Direct Palpation | — | 0/62 (0%) | 14/62 (22.6%) |
| Ultrasound | — | 0/63 (0%) | 7/63 (11.1%) |
| Event | Direct Palpation | Ultrasound |
|---|---|---|
| hematomaVascular disorders | 14/62 | 7/63 |
| Age, Continuous(years) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Mean | 67 ± 14 | 67 ± 14 | 67 ± 14 |
| Sex: Female, Male(Participants) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Female | 16 | 11 | 27 |
| Male | 46 | 52 | 98 |
| Region of Enrollment(participants) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Canada | 62 | 63 | 125 |
| Body Mass Index(kg/m^2) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Mean | 27 ± 5 | 26 ± 4 | 26.5 ± 4.5 |
| ASA physical status IV(participants) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Number | 61 | 59 | 120 |
| Peripheral vascular disease(participants) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Number | 3 | 3 | 6 |
| Systolic Blood Pressure(mm Hg) | Direct Palpation | Ultrasound | Total |
|---|---|---|---|
| Mean | 140 ± 18 | 140 ± 21 | 140 ± 19.5 |
This study is completed, as verified in Apr 2015. You cannot join it, but the record below documents what was studied.
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University of British Columbia