Catheterization, Peripheral Clinical Trial
Official title:
Comparison of the Efficacy of Radial Artery Catheterization in Three Different Regions in Intensive Care Patients
In this prospective, randomized, open-labeled study, the intensive care patients will be selected for ultrasound-guided cannulation of the radial artery in three different regions. Patients will be divided into three groups with simple randomization. The first group will be determined as 'G1' and the radial artery catheterization with ultrasound-guided short axis out of plane intervention will be performed over 2 cm of the wrist for this group. On the second group (G2), radial artery catheterization will be performed in the distal 3/4 area of the forearm with ultrasound-guided short axis out of plane intervention. On the third group (G3), radial arterial catheterization will be performed in the distal 1/2 area of the forearm with ultrasound-guided short axis out of plane interference. Whether there is a difference in the duration of use of arterial cannula, first entry success rates, duration of intervention, number of procedures, the number of cannulas used and the effects on early and late complications and advantages between the groups will be investigated.
In patients requiring frequent arterial blood gas sampling in the intensive care unit and in
cases requiring continuous blood pressure monitoring, arterial cannulation is preferred. The
use of USG has also become widespread in anesthesia practice. It is supported by studies that
USG-guided interventions cause fewer complications compared to classical methods and reduce
intervention time. USG-guided arterial catheterization method is based on the principle of
direct visualization of the artery and catheter via USG. In this technique, the catheter and
the needle tip are displayed simultaneously with the USG guided to the artery lumen. Imaging
of anatomical structures with USG has resulted in a reduction of complications and shortening
of the processing time. In the USG screen, adjacent anatomical formations such as veins and
nerve structures are simultaneously displayed. This reduces the risk of complications.
Two different techniques are used for USG mediated radial artery cannulation. The first one
is the in-plane technique, which forms the long axis image of the arteries by positioning the
USG probe to parallel to the vein, and the second is the out-of-plane technique, which forms
a short axis image with the probe positioned perpendicular to the arteries.
The ideal location of radial artery catheterization with USG or the advantages/disadvantages
of the catheterization zone are not available.
In this randomized prospective and open-label study, patients will be divided into three
groups. The first group will be determined as 'G1' and the radial artery catheterization with
ultrasound-guided short axis out of plane intervention will be performed over 2 cm of the
wrist for this group. On the second group (G2), radial artery catheterization will be
performed in the distal 3/4 area of the forearm with ultrasound-guided short axis out of
plane intervention. On the third group (G3), radial arterial catheterization will be
performed in the distal 1/2 area of the forearm with ultrasound-guided short axis out of
plane interference. Comparison of these three groups, in terms of duration of use of arterial
cannula, initial entry success rates, duration of intervention, number of procedures used,
number of cannulas used and effects on early and late complications, and advantages if any is
intended.
Patients will be randomly distributed to three groups. Diagnosis, age, sex, height, weight,
and body mass index of the patients will be recorded. The random distribution of obese
patients to groups will be ensured. Allen test will be done to the patients before the
intervention. Radial artery catheterization will be applied only to patients with the
collateral flow. Each group will be measured and recorded before, during and after the
intervention. Before the intervention, local anesthetic infiltration will be applied and
asepsis will be provided. Early complications (such as hematoma, hemorrhage) and late
complications (such as circulatory disorders) will be observed and recorded.
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