title: Ultrasound-guided radial artery catheterization in infants and small children.
abstract: OBJECTIVE
  To determine whether ultrasound guidance increases the success rates, decreases the complication rates, and shortens the time to successful radial artery catheterization in infants and small children.
  
  
  METHODS
  Randomized study.
  
  
  METHODS
  Single university-affiliated hospital.
  
  
  METHODS
  Infants and children weighing 3-20 kg, undergoing cardiac surgery for congenital heart disease.
  
  
  METHODS
  We randomly assigned the right and left radial arteries of patients undergoing arterial catheterization to ultrasound-guided technique versus the usual palpation technique.
  
  
  METHODS
  The primary study endpoints were the rates of successful cannulation at first and within three attempts. The secondary endpoints were time to radial artery identification, number of attempts for successful cannulation, and rate of complications.
  
  
  RESULTS
  Compared with palpation, ultrasound-guided radial artery catheterization was successful in 76.3% versus 35.6% of first attempts and in 94.9% versus 50.8% of arteries after three attempts (both comparisons, p < 0.01). The median time [interquartile range] to identification of the arteries (18.5 seconds [11.25-27.25] vs 30 seconds [17.75-39.5]) was significantly shorter (p < 0.01), the number of attempts [interquartile range] at successful cannulation (1 [1-1] vs 2 [1-2]) was significantly fewer (p < 0.01), and the proportion of hematomas (5.1% vs 25.4%) was significantly lower (p < 0.01) in the ultrasound group than those in the palpation group.
  
  
  CONCLUSIONS
  In infants and small children, ultrasound-guided radial artery catheterization was more successful and expeditious than the usual palpation technique.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Ishii
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Shime
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shibasaki
authors.forename: Teiji
authors.initials: T
authors.lastname: Sawa
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D010173:Palpation; D017534:Radial Artery / Q000000981:diagnostic imaging*; D014463:Ultrasonography