Arterial Cannulation With Ultrasound

NCT05249036 | Terminated

• 1 other identifier: 301584
• Study Type: interventional
• Target: 57
• Locations: 1 country
• Sites: 1

Brief Summary

A drop in blood pressure during anaesthesia for a surgical procedure has been associated with worse patient outcomes, including complications such as damage to the heart, brain and kidneys. Continuous blood pressure monitoring prior to the start of anaesthesia alerts the anaesthetist to drops in blood pressure and allows this to be treated promptly. This may help to avoid the complications described above. Continuous blood pressure monitoring is carried out by inserting a small plastic tube (cannula) into an artery. In this study, the investigators propose inserting a cannula into the radial artery in the wrist before a patient is anaesthetised for surgery. The usual technique for insertion of this cannula is for the anaesthetist to identify the site of the radial artery by feeling for an arterial pulse with the fingertips (palpation). An alternative technique for identification is to use ultrasound. Ultrasound creates a two-dimensional image of the area under the skin on a screen, enabling the operator to visualise the artery being targeted. This may reduce the number of cannulation attempts required, reducing patient discomfort.

Conditions

Perioperative/Postoperative Complications

Keywords

Arterial cannulation; Ultrasound

Outcome Measures

Primary Outcomes (1)

• Success rate at first attempt to cannulate the radial artery

  Success is defined as radial artery cannulation resulting in a transduced arterial waveform. First attempt is defined as one needle puncture through the skin.

  10 minutes

Secondary Outcomes (2)

• Characteristics of arterial waveform

  Within 15 mins of catheterisation.

• Complications

  24 hours

Study Arms (2)

Ultrasound guided arterial cannulation

EXPERIMENTAL

Anaesthetist will use real-time ultrasound guidance to guide arterial cannulation

Procedure: Ultrasound guided arterial cannulation

Palpation guided arterial cannulation

ACTIVE COMPARATOR

Anaesthetist will use palpation (standard-of-care) technique to guide arterial cannulation

Procedure: Palpation guided arterial cannulation

Interventions

Ultrasound guided arterial cannulation PROCEDURE

Arterial cannulation will be attempted at the site of the radial artery of the non-dominant hand, using real-time ultrasound guidance

Ultrasound guided arterial cannulation

Palpation guided arterial cannulation PROCEDURE

Arterial cannulation will be attempted at the site of the radial artery of the non-dominant hand, using palpation technique (standard-of-care)

Palpation guided arterial cannulation

Eligibility Criteria

• Age: 45 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled to undergo major elective or urgent (not requiring intervention in \<24 hours) non-cardiac surgery under general anaesthesia and/or neuraxial anaesthesia, expected to take \>120 minutes from induction of anaesthesia
• Requiring overnight hospital stay.

You may not qualify if:

• Anatomical deformity
• Unable to consent
• Cannulation attempt within 24 hours
• Overlying infection

Sponsors & Collaborators

• Queen Mary University of London: lead
• The London Clinic: collaborator

Study Sites (1)

Royal London Hospital

London, E1, United Kingdom

Location

Related Publications (1)

• Lan-Pak-Kee V, Ackland GL, Egan TC, Abbott TE, Elsheikh F; Arterial Cannulation with Ultrasound Investigators. Arterial cannulation with ultrasound: clinical trial protocol for a randomised controlled trial comparing handheld ultrasound versus palpation technique for radial artery cannulation. BJA Open. 2022 Dec;4:None. doi: 10.1016/j.bjao.2022.100111.

  PMID: 36561483 DERIVED

MeSH Terms

Conditions

Postoperative Complications

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Gareth L Ackland, PhD FRCA

  Translational Medicine & Therapeutics, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 26, 2022
• First Posted: February 21, 2022
• Study Start: December 25, 2021
• Primary Completion: November 30, 2023
• Study Completion: November 30, 2023
• Last Updated: August 15, 2024

Record last verified: 2024-08

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)