Abstract
ObjectiveThis study aimed to determine the associations between the first-attempt success and arterial depth in ultrasound-guided radial artery catheterization (RAC) with dynamic needle tip positioning (DNTP) technique. This study also aimed to further explore the cut-off depth correlated to improved first-attempt success catheterization in less time.MethodsThe cases undertaken by RAC within the DNTP technique between March 2019 and July 2020 were extracted from our institutional cohort database. Relevant variables were collected, including patients' demographics and catheterized information. Univariable and multivariable logistic regression analyses were performed to determine the association. The receiver operating characteristic (ROC) curve and the Youden index were used to explore the cut-off values of the arterial depth. Categorized cases according to the cut-off values, the Kaplan-Meier analysis, and the log-rank test were used to determine the difference of first-attempt success with limited catheterized time between groups.ResultsIn this study, 119 patients were enrolled and 98 achieved first-attempt success. The first-attempt success catheterization was observed to be correlated to arterial depth (p < 0.01, odds ratio 6.47). An optimal cut-off depth of 2.25 mm was found using the Youden index (0.53) by ROC curve (area under curve 0.77). Arterial depth of more than 2.25 mm was correlated to improved first-attempt success catheterization in less time (log-rank p < 0.01).ConclusionTo achieve first-attempt success catheterization using the DNTP technique, an arterial depth of more than 2.25 mm was associated with less catheterized time.
Highlights
In anesthesia, intensive care, and emergent medicine, radial artery catheterization (RAC) is a significant procedure, that allows real-time blood pressure administration and provides convenient blood sampling when needed
The first-attempt success catheterization was observed to be correlated to arterial depth (p < 0.01, odds ratio 6.47)
Arterial depth of more than 2.25 mm was correlated to improved first-attempt success catheterization in less time
Summary
Intensive care, and emergent medicine, radial artery catheterization (RAC) is a significant procedure, that allows real-time blood pressure administration and provides convenient blood sampling when needed. As mentioned in the meta-analysis of 12 randomized control studies enrolled 2,432 adult participants, which suggests ultrasound-guided DNTP technique and long-axis view performed better than conventional short-axis technique in improving first-attempt success [7]. Though both the DNTP technique and long-axis view are committed to discriminating the needle tip, using the DNTP technique hardly worry about the time-consumption of vascular imaging [11] and losing target because of thickness artifacts [12]
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