■动态针尖定位技术代表了用于桡动脉导管插入术的短轴平面外超声引导方法的高级版本。该研究旨在探索能够在临床环境中迅速准确地执行该程序的最有效的插入位点。
■一项前瞻性随机对照研究涵盖了246名需要进行有创动脉监测的择期手术患者。参与者被随机分配到三个不同的组:部位1(针对桡骨茎突),站点2(站点1和3之间的中途),和部位3(前臂远端三分之一)。在所有组中实施动态针尖定位技术。关键参数,如首次尝试成功率,成功的时间,总体成功率,总导管插入时间,尝试次数,和并发症,精心记录和比较。
■与站点1相比,站点2队列的首次尝试成功率显着提高(97.5%vs80%,p=0.003)和站点3(97.5%对81.25%,p=0.006)。此外,与站点1(31.5vs38,p=0.003)和站点3(31.5vs40,p=0.006)相比,站点2显示出缩短的成功时间。与位置1(32vs42.5,p<0.001)和位置3(32vs43.5,p<0.001)相比,位置2的总导管插入时间显著缩短。站点2需要比站点1(p=0.02)和站点3(p=0.03)更少的尝试。男性和部位2处的穿刺与快速成功时间相关。与站点1组相比,站点3组的不良事件发生率更高(15%vs3.75%,p=0.03)和站点2组(15%对2.5%,p=0.01)。
■在成年患者中,利用动态针尖定位技术的超声引导桡动脉导管插入术的最佳插入部位位于桡骨茎突和前臂远端三分之一之间的中间位置。
UNASSIGNED: The dynamic needle tip positioning technique represents an advanced version of the short-axis out-of-plane ultrasound-guided approach employed for radial artery catheterization. The study aimed to explore the most effective insertion site capable of expeditiously and accurately executing the procedure in a clinical setting.
UNASSIGNED: A prospective randomized controlled study encompassed 246 elective surgery patients necessitating invasive arterial monitoring. Participants were randomly assigned to three distinct groups: Site 1 (targeting the radial styloid process), Site 2 (midway between Sites 1 and 3), and Site 3 (distal one-third of the forearm). The dynamic needle tip positioning technique was implemented across all groups. Crucial parameters, such as first-attempt success rate, time to success, overall success rate, total catheterization time, number of attempts, and complications, were meticulously documented and compared.
UNASSIGNED: The Site 2 cohort presented a significantly heightened first-attempt success rate compared to Site 1 (97.5% vs 80%, p = 0.003) and Site 3 (97.5% vs 81.25%, p = 0.006). Moreover, Site 2 displayed a reduced time to success in contrast to Site 1 (31.5 vs 38, p = 0.003) and Site 3 (31.5 vs 40, p = 0.006). Total catheterization time was significantly shorter in Site 2 compared to Site 1 (32 vs 42.5, p < 0.001) and Site 3 (32 vs 43.5, p < 0.001). Site 2 necessitated fewer attempts than Site 1 (p = 0.02) and Site 3 (p = 0.03). Male gender and puncture at Site 2 were associated with expedited time to success. Adverse events manifested more frequently in the Site 3 group compared to the Site 1 group (15% vs 3.75%, p = 0.03) and the Site 2 group (15% vs 2.5%, p = 0.01).
UNASSIGNED: The optimal insertion site for ultrasound-guided radial artery catheterization utilizing the dynamic needle tip positioning technique in adult patients is situated midway between the radial styloid process and the distal one-third of the forearm.