• Julien Raft, Léo Coinus, Anne-Sophie Lamotte, Côme Slosse, Isabelle Clerc-Urmès, Cédric Baumann, Philippe Richebé, and Hervé Bouaziz.
• Department of Anesthesiology, Cancer Institut of Lorraine, Vandoeuvre-les-Nancy, France; and INSERM UMR-S 1116 Equipe 2, University of Lorraine, Nancy, France. julien.raft@free.fr.
• Respir Care. 2022 Sep 1; 67 (9): 115411601154-1160.

BackgroundArterial cannulation is an important procedure for hemodynamic monitoring and blood sampling. Traditional radial artery cannulation is performed by using anatomical knowledge and pulse palpation as a guide. Arterial cannulation using ultrasound (US) requires specific training, especially for new US users. We hypothesized that even for new US users, US guidance would facilitate the successful puncture by lower attempts before successful intraluminal cannulation of a simulation model of the radial artery.MethodsA prospective randomized controlled crossover study was conducted with new US users on a gelatin phantom wrist. Three sessions of training were proposed: US-guided technique with low blood pressure (BP), palpation-guided technique with high BP, and one secondary comparison with low BP. For the 2 first sessions, all volunteers performed each technique but not in the same order. The main criterion was the number of attempts before successful catheterization of the model artery. A secondary criterion was the number of needle movements (the number of attempts plus the number of needle directional changes).ResultsTwenty new US users participated in the study. Numbers of attempts before successful catheterization were significantly lower when using the US technique: 1.1 (± 0.4) for US versus 1.6 (± 0.8) for palpation high BP (P = .02) versus 2.5 (± 1.4) for the secondary comparison, palpation low BP (P < .001). All of the participants achieved success after the 12th needle movement for US technique, after the 19th needle movement for palpation high BP, and after the 25th needle movement for the secondary comparison, palpation low BP. The total time before success was not significantly different between the 2 first sequences (US vs palpation high BP).ConclusionsUS technique was more successful than traditional palpation technique for novice US users performing arterial cannulations for the first time. A study in the clinical practice is needed to confirm these results.Copyright © 2022 by Daedalus Enterprises.

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