Comparison of Procedural Techniques and Variables in Patients Undergoing Arterial Cannulation

Year 2025, , 7 - 12, 29.01.2025

Nazif Yalçın , Aysegul Ertınmaz Ozkan , Nizameddin Koca

https://doi.org/10.56016/dahudermj.1588898

Abstract

Background: This study presents a comprehensive comparative analysis of two methods for arterial cannulation, palpation, and ultrasound guidance (USG), using a sample of 104 subjects for each method.
Methods: The primary objective was to evaluate the safety and efficiency of these techniques. Clinical and laboratory parameters were recorded, including hemoglobin levels, platelet count, International Normalized Ratio (INR), albumin, and total protein levels. The number of attempts and total procedure time were documented for each procedure. Additionally, the ultrasound-guided (USG) method and the duration of each recorded procedure were emphasized to provide a detailed comparison between the two techniques.
Results: USG required fewer attempts than palpation (1.63 ± 0.83 vs. 2.36 ± 1.18, p<0.001), resulting in a higher success rate on the first attempt. The total procedure time was significantly shorter in the USG group (7.14 ± 2.42 vs. 11.83 ± 4.45 minutes, p<0.001). This demonstrates the enhanced efficiency of USG. Complication rates were also lower in the USG group (16.3% vs. 31.7%, p=0.009), confirming its safety advantage.
Although the two groups showed no significant differences in hemoglobin levels, platelet count, albumin, total protein levels, inotropic agent requirements, or history of peripheral arterial disease (PAD) and congestive heart failure (CHF), INR levels were significantly higher in the USG group (1.23 ± 0.26 vs. 1.14 ± 0.25, p=0.004). Furthermore, patients with higher BMI benefited more from USG, which was particularly advantageous in challenging cases.
Conclusion: The current study demonstrates that USG is more efficient, safer, and quicker than palpation, particularly in patients with a higher BMI. These findings suggest that USG is preferable for arterial cannulation in clinical settings, offering reduced complications and enhanced success rates, especially in more challenging patient populations.

Keywords

arterial cannulation, cannulation techniques, dorsalis pedis artery

Ethical Statement

ethical principles outlined in the Declaration of Helsinki and received approval from Bursa Şehir Training and Research Hospital’s Ethical Committee (Approval Number: 2023-18/10). The research was carried out on patients admitted to the Internal Medicine Intensive Care Unit at Bursa Şehir Training and Research Hospital, which is affiliated with the University of Health Sciences. Informed consent was obtained from all participants or their legal representatives prior to their inclusion in the study. All patient data were handled with strict confidentiality and in compliance with data protection regulations.

Arteriyel Kanülasyon Uygulanan Hastalarda İşlem Teknikleri ve Değişkenlerin Karşılaştırılması

Abstract

Özet:
Amaç: Bu çalışma, her yöntem için 104 kişiden oluşan bir örneklem kullanılarak arteriyel kanülasyon, palpasyon ve ultrason rehberliğinde (USG) iki yöntemin kapsamlı bir karşılaştırmalı analizini sunmaktadır.
Yöntemler: Birincil amaç, bu tekniklerin güvenliğini ve verimliliğini değerlendirmekti. Hemoglobin seviyeleri, trombosit sayısı, Uluslararası Normalleştirilmiş Oran (INR), albümin ve toplam protein seviyeleri dahil olmak üzere klinik ve laboratuvar parametreleri kaydedildi. Her prosedür için deneme sayısı ve toplam prosedür süresi belgelendi. Ek olarak, iki teknik arasında ayrıntılı bir karşılaştırma sağlamak için ultrason rehberliğindeki (USG) yöntem ve kaydedilen her prosedürün süresi vurgulandı.
Sonuçlar: USG, palpasyondan daha az deneme gerektirdi (1,63 ± 0,83'e karşı 2,36 ± 1,18, p<0,001), bu da ilk denemede daha yüksek bir başarı oranıyla sonuçlandı. Toplam işlem süresi USG grubunda önemli ölçüde daha kısaydı (7,14 ± 2,42 - 11,83 ± 4,45 dakika, p<0,001). Bu, USG'nin artan verimliliğini göstermektedir. Komplikasyon oranları da USG grubunda daha düşüktü (%16,3 - %31,7, p=0,009), bu da güvenlik avantajını doğrulamaktadır.
İki grup arasında hemoglobin seviyeleri, trombosit sayısı, albümin, toplam protein seviyeleri, inotropik ajan gereksinimleri veya pulmoner arteriyel hipertansiyon (PAH) ve konjestif kalp yetmezliği (CHF) öyküsü açısından önemli bir fark görülmese de, INR seviyeleri USG grubunda önemli ölçüde daha yüksekti (1,23 ± 0,26 - 1,14 ± 0,25, p=0,004). Ayrıca, daha yüksek BMI'ye sahip hastalar USG'den daha fazla yararlandı ve bu özellikle zorlu vakalarda avantajlıydı.
Sonuç: Mevcut çalışma, USG'nin özellikle daha yüksek BMI'li hastalarda palpasyondan daha etkili, daha güvenli ve daha hızlı olduğunu göstermektedir. Bu bulgular, USG'nin klinik ortamlarda arteriyel kanülasyon için tercih edilebilir olduğunu, özellikle daha zorlu hasta popülasyonlarında daha az komplikasyon ve artırılmış başarı oranları sunduğunu göstermektedir.

Keywords

arteryal kanulasyon, kanulasyon teknikleri

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