Femoral arterial cannulation performed by residents: a comparison between ultrasound-guided and palpation technique in infants and children undergoing cardiac surgery
| Autor: | Marie T. Aouad, Roland N. Kaddoum, Muhammad H. Ibrahim, Sahar M. Siddik-Sayyid, Maud Nawfal, Youssef J. Tfaili, Samar K. Taha |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Femoral artery Palpation 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine.artery Catheterization Peripheral medicine Humans Prospective Studies Cardiac Surgical Procedures Prospective cohort study Child Ultrasonography Interventional medicine.diagnostic_test business.industry Ultrasound Infant Internship and Residency 030208 emergency & critical care medicine Odds ratio Confidence interval Surgery Cardiac surgery Femoral Artery Anesthesiology and Pain Medicine Anesthesia Child Preschool Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Paediatric anaesthesia. 26(8) |
| ISSN: | 1460-9592 |
| Popis: | Summary Background Percutaneous cannulation of the femoral artery in the pediatric age group can be technically challenging, especially when performed by residents in training. Objective We examined whether the use of real-time ultrasound guidance is superior to a palpation landmark technique for femoral artery catheterization in children undergoing heart surgery. Methods Patients were prospectively randomized into two groups. In the palpation group, the femoral artery was cannulated using the traditional landmark method of palpation of arterial pulse. In the ultrasound group, cannulation was guided by real-time scanning with an ultrasound probe. Ten minutes were set as time limit for the resident's trials during which the time taken for attempted cannulation (primary outcome), number of attempts, number of successful cannulations on first attempt, and success rate were compared between the two groups. Adverse events were monitored on postoperative days 1 and 3. Results A total of 106 patients were included in the study. The time taken for attempted femoral artery cannulation was shorter (301 ± 234 vs 420 ± 248 s; difference in mean: 119; 95% confidence interval (CI) of difference: 26–212; P = 0.012) and the number of attempts was lower [1 (1–10) vs 2 (1–5); difference in median: 1, 95% CI of difference: 0.28–1.72; P = 0.003] in the ultrasound group compared with the palpation group. The number of successful cannulations on first attempt was higher in the ultrasound group compared with palpation group [24/53 (45%) vs 13/53 (25%); odds ratio (OR): 2.54, 95% CI: 1.11–5.82; P = 0.025]. The number of patients who had successful cannulation was 31 of 55 (58%) in the palpation group and 40 of 53 (75%) in the ultrasound group (OR: 2.18, 95% CI: 0.95–5.01; P = 0.06). None of the patients had adverse events at days 1 and 3. Conclusions Ultrasound-guided femoral arterial cannulation in children when performed by anesthesia residents is superior to the palpation technique based on the reduction of the time taken for attempted cannulation and the number of attempts, and improvement in first attempt success. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|