A RANDOMIZED COMPARISON OF ULTRASOUND GUIDED VERSUS BLINDLY PLACED RADIAL ARTERIAL CATHETERS

Abstract

Objective: To evaluate the effectiveness of ultrasound (US) guided radial artery
cannulation as compared to the blind insertion of arterial line in intensive care
unit of a tertiary care center.
Methodology: One hundred patients were divided into two equal groups. In
group I, arterial line was inserted using the blind palpation technique. While in
group II, arterial line was inserted with the help of ultrasound guidance. The primary
endpoints were time of insertion in 1st attempt, number of first successful
attempts and maximum number of attempts used for insertion of arterial line.
Data was analyzed by using SPSS V23. Chi-square test was used for analysis of
gender and successful insertion in 1st attempt. Independent sample t-test and
Mann-Whitney U-test were used to compare quantitative variables.
Results: Mean baseline systolic blood pressure, mean diastolic blood pressure
and mean pulse rate before surgery were also not significantly different between
the groups. Arterial line was inserted in first attempt in in 88.0% patients
in ultrasound guided group and in only 70.0% patients in blind palpation group
(p-value 0.027). Arterial line insertion time in 1st attempt was also significantly
less in ultrasound guided group 77.68±7.98 seconds versus 95.46±15.53 seconds
in blind palpation group (p-value <0.001). We also found less number
of attempts 1.16±0.37 in ultrasound guided group versus 1.44+0.67 in blind
palpation group (p-value 0.025).
Conclusion: Ultrasound guided radial artery cannulation is associated with
higher rate of successful insertion and less time is required for arterial line insertion
as compared to blind palpation method.