Application of ultrasound-guided radial artery cannulation in paediatric patients: A systematic review and meta-analysis. Issue 4 (July 2021)

• Record Type: Journal Article
• Authors: Huang, Hua-ping; Zhao, Wen-jun; Wen, Fang; Li, Xiao-yu
• Is Part Of: Australian critical care. Volume 34:Issue 4(2021)
• Page Start: 388
• Page End: 394
• Publication Date: 2021-07
• Subjects: Cannulation -- Paediatric -- Radial artery -- Ultrasound; Intensive care nursing -- Periodicals; Intensive care nursing -- Australia -- Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.aucc.2020.09.001
• Languages: English
• ISSNs: 1036-7314

Abstract

Abstract: Background: Numerous studies have demonstrated the benefits and safety of ultrasound guidance in comparison with conventional palpation for radial artery cannulation in adult patients. However, the current evidence for paediatric patients is not fully understood. Objective: The objective of this study was to compare the efficiency and safety of ultrasound guidance with those of traditional palpation for radial artery cannulation in paediatric patients and provide convincing evidence for clinical practice. Methods: PubMed, Cochrane Library, ClinicalTrials.gov (Min et al-2019, NCT02795468, Anantasit et al-2017, NCT02668471 ), China National Knowledge Infrastructure, and Wanfang Data were systematically searched from their inception until December 31, 2019, to identify relevant randomised controlled trials. Data were extracted from the included studies independently by two investigators. The primary outcome of interest was the first-attempt success rate. Review Manager Version 5.3 and trial sequential analysis (beta = 0.9) were applied to analyse the collected data. Results: A total of eight randomised controlled trials involving 680 paediatric patients were included in this study. The pooled findings showed that ultrasound-guided radial artery cannulation, in comparison with traditional palpation, can significantly improve the first-attempt success rate (relative risk [RR] = 1.65, 95% confidence interval [CI] = 1.36–2.01, P < 0.00001). Trial sequential analysis indicated that this available evidence was conclusive. Moreover, ultrasound guidance was associated with an increased total success rate (RR = 1.38, 95% CI = 1.15–1.66, P = 0.0004), a decreased mean procedural time (standardised mean difference = −0.89, 95% CI = −1.52 to −0.25, P = 0.006), and incidence of haematoma (RR = 0.19, 95% CI = 0.10–0.35, P < 0.00001). Conclusion: Ultrasound-guided radial arterial cannulation in paediatric patients is associated with improved first-attempt success rates, total success rates, and mean procedural time and decreased incidence of haematoma. The current evidence suggests that ultrasound guidance should be the standard of care for radial artery cannulation in clinical practice.