Disorder of Cardiac Function Clinical Trial
Official title:
Conventional vs Ultrasound Guided Arteria Cannulation
The aim of the project is to compare two methods for arterial cannulation. The traditional method with ultrasound guided cannulation. The investigators goal is to improve this procedure to reduce pain and complications.
The practice of placing vascular catheters is used many times every day at almost every
hospital. It is a safe procedure which generally does not imply problems. Though the
procedural optimum aren't reached. The procedure still fails some times and induce
complications. When the catheter is placed using the traditional method the pulse is
palpated by the operator's fingers. This is only to be done near the hand wrist. In this
position the catheter steadiness is fragile but because the pulse can't be sensed more
proximal the operator is forced to choose this position. This it though a problem that can
be solved by non invasive visualization technology. Ultrasound-guidance for central vascular
access is already well-established. However, in recent years ultrasound-guidance for
peripheral vascular access has gained popularity too. The evidence of multiple studies
demonstrates increased success rate and reduced complication rate with ultrasound compared
to blind landmark technique for vascular catheter placement.
In recent years there have been both procedural technique and technology improvements in the
field of ultrasound. This has led to the improvement of procedural catheterisation
techniques that now can be done by novices with higher attempt success rate than traditional
method. One technique that is gaining success is the short-axis-out-of-plane technique
(SAX-OOP) with dynamic-needle-tip-tracking (DNTT).Using the ultrasound machine the needle
can be placed in a more proximal direction on the forearm and the investigators believe that
by the help of the exposed procedure on the monitor many complications can be reduced.
It has been shown that inexperienced trainees lear the technique SAX-OOP and DNTT very
quickly.
First investigators hypothesize that the number of attempts, the number of withdrawals, the
time spend and the number of utilized catheters will be decreased using ultrasound vs. the
traditional method. Secondly investigators hypothesize that the pain induced by the
conventional method inclusive preoperational lidocaine injection will be the same or more
intense than using DNTT with local anesthesia. Thirdly investigators claim that the best
anatomical place to put the catheter isn't always corresponding with the spot chosen by
palpation, which increase the number of failures. Fourthly investigators hypothesize that
the use of ultrasound will increase the operator's subjective feeling of having accomplished
a successful procedure.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject)