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Effect of bevel direction on the success rate of ultrasound-guided radial arterial catheterization

Cited 3 time in Web of Science Cited 1 time in Scopus
Authors
Min, Sung-Won; Cho, Hyong-Rae; Jeon, Young-Tae; Oh, Ah-Young; Park, Hee-Pyoung; Yang, Chun Woo; Choi, Woo Hee; Kim, Byung-Gun
Issue Date
2016-07-11
Publisher
BioMed Central
Citation
BMC Anesthesiology, 16(1):34
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Abstract
Abstract

Background
This study assessed the effect of bevel direction on the success rate of ultrasound guided radial artery catheterization.


Methods
A total of 204 patients requiring radial artery catheterization were randomly divided into bevel-up (n = 102) and bevel-down (n = 102) groups. Success rate, cannulation time, and number of attempts were compared groups.


Results
In the bevel-down group, an arterial line was placed on the first attempt in 86 of 102 (84.3 %; 95 % confidence interval [CI] = 76 % to 90 %) patients versus 73 of 102 (71.6 %; 95 % CI = 62.1 % to 79.4 %) in the bevel-up group (p = 0.028). In the bevel-down group, the mean time to a successful radial arterial cannulation was 33.3 ± 6.3 seconds (95 % CI = 32.1-34.6) versus 35.9 ± 7.6 seconds (95 % CI = 34.4-37.2) in the bevel-up group (p = 0.011). The median score was 33.2 and interquartile range [IQR] was 10.9 (30.3-41.2) for the mean cannulation time in the bevel-up group. In the bevel-down group, the mean score was 32.3 (IQR 3.90, 30–33.9) for mean cannulation time. In the bevel-down group, 11 of 102 (7 %; 95 % CI = 0 to 16 %) patients developed a posterior wall puncture versus 22 of 102 ((21.6 %; 95 % CI = 14.7 to 17.2 %) in the bevel-up group.


Conclusion
The bevel-down approach during ultrasound-guided radial artery catheterization exhibited a higher success with fewer complications compared to the bevel-up approach.


Trial registration
Clinical Research Information Service is Korean Clinical Trials Registry (
KCT0001836

). It was registered retrospectively 30th Nov 2015.
Language
English
URI
https://hdl.handle.net/10371/100433
DOI
https://doi.org/10.1186/s12871-016-0202-5
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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