Ultrasound-Guided Radial Artery Catheterization in Infants and Small Children

摘要

Arterial catheterization is an indispensible technique for pediatric critical care physicians. However, because of the small vessels, the technique is particularly challenging in small children and infants, resulting in multiple attempts; complications, such as hematoma, hemorrhage, and arterial occlusion; and lengthy procedures (1, 2). Ultrasound guidance is now commonly used for central vein catheterization in children. A previously published meta-analysis supported the greater success rate, speed, and safety of ultrasound guidance, compared with the traditional landmark techniques (3). Ultrasound-guided central vein catheterization was particularly useful in small children (4,5). On the other hand, few studies have examined the performance of ultrasound-guided arterial cannulation in pediatric populations, and the results have been conflicting (6,7). Furthermore, no attempt has been made to evaluate its usefulness in small children and infants, in whom the usual palpation technique is particularly difficult. The purpose of this study was to compare ultrasound-guided arterial cannulation with the usual palpation method in infants and small children undergoing cardiac surgery.