Efficacy of ultrasound-guided radial artery
catheterization: a systematic review and
meta-analysis of randomized controlled trials
Wan-Jie Gu1, Hong-Tao Tie2, Jing-Chen Liu1* and Xian-Tao Zeng3
Gu et al. Critical Care 2014, 18:R93
http://ccforum.com/content/18/3/R93AbstractIntroduction: Ultrasound guidance has emerged as an adjunct for central vein catheterization in both adults and
children. However, the use of ultrasound guidance for radial arterial catheterization has not been well established.
We conducted a systematic review and meta-analysis to evaluate the efficacy of ultrasound guidance for radial
artery catheterization.
Ovviamente pur riconoscendo l'efficacia e della maggiore sicurezza dell'incannulamento attraverso la guida ecografica (anche sei bambini piccoli e neonati) si pone l'attenzione sull'interpretazione dei risultati vista l'eterogenicità degli studi analizzati.
Gu et al. Critical Care 2014, 18:R93
http://ccforum.com/content/18/3/R93AbstractIntroduction: Ultrasound guidance has emerged as an adjunct for central vein catheterization in both adults and
children. However, the use of ultrasound guidance for radial arterial catheterization has not been well established.
We conducted a systematic review and meta-analysis to evaluate the efficacy of ultrasound guidance for radial
artery catheterization.
Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized
controlled trials (RCTs) comparing ultrasound guidance with other techniques (palpation or Doppler) in adult or
pediatric patients requiring radial artery catheterization were included. The primary outcome was first-attempt
success.
Results: Seven RCTs enrolling 546 patients met the inclusion criteria, and all the selected trials were considered as
at high risk of bias. Ultrasound-guided radial artery catheterization was associated with an increased first-attempt
success (relative risk (RR) 1.55, 95% confidence interval (CI) 1.02 to 2.35). There was significant heterogeneity among
the studies (I2 = 74%). Ultrasound-guided radial artery catheterization in small children and infants also provided an
increased chance for first-attempt success (RR 1.94, 95% CI 1.31 to 2.88). Ultrasound guidance further significantly
reduced mean attempts to success (weighted mean difference (WMD) −1.13, 95% CI −1.58 to −0.69), mean time
to success (WMD −72.97 seconds, 95% CI −134.41 to −11.52), and incidence of the complication of hematoma
(RR 0.17, 95% CI 0.07 to 0.41).
Conclusions: Ultrasound guidance is an effective and safe technique for radial artery catheterization, even in
small children and infants. However, the results should be interpreted cautiously due to the heterogeneity among
the studies.
Ovviamente pur riconoscendo l'efficacia e della maggiore sicurezza dell'incannulamento attraverso la guida ecografica (anche sei bambini piccoli e neonati) si pone l'attenzione sull'interpretazione dei risultati vista l'eterogenicità degli studi analizzati.
