US Guidance for Radial Arterial Puncture in Shock

NCT07362628 | Completed

• 1 other identifier: September 11, 2024 ID: 20-09
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Doctors in the emergency department often need to take blood samples from an artery to understand how well a patient is breathing and how the body is responding to serious illness. This is usually done by inserting a needle into an artery at the wrist. In patients with shock, this procedure can be difficult because blood pressure is low and the pulse may be hard to feel. In this study, two different methods for obtaining arterial blood samples were compared in adult patients presenting to the emergency department with shock. In one group, the radial artery puncture was performed with ultrasound guidance, allowing direct visualization of the artery. In the other group, the procedure was carried out using the conventional palpation technique based on manual detection of the pulse. Patients were randomly assigned to one of the two techniques. The study assessed the success of the procedure on the first attempt, the total number of attempts required, the time needed to obtain a successful sample, and whether puncture of the femoral artery was required when radial access could not be achieved. The aim of the study was to evaluate whether the use of ultrasound improves the efficiency and success of radial artery blood sampling in patients with shock treated in the emergency department.

Conditions

Shock; Shock Circulatory

Keywords

Arterial blood gas; Emergency department; Radial artery puncture; Shock; Ultrasound

Outcome Measures

Primary Outcomes (1)

• First-Attempt Success of Radial Artery Puncture

  In the ultrasound-guided group, a stopwatch was started when the ultrasound transducer made contact with the skin over the radial artery. The artery was visualized on the screen, and the needle was advanced under real-time ultrasound guidance until arterial blood flow was obtained. The stopwatch was stopped when arterial blood flow was observed in the syringe, and the procedure was considered successful. Each new puncture attempt was recorded as a separate attempt. In the conventional palpation group, a stopwatch was started when the physician made skin contact after identifying the radial artery by palpation. The needle was advanced into the radial artery until arterial blood flow was obtained. The stopwatch was stopped when arterial blood flow was observed in the syringe, and the procedure was considered successful. Each new puncture attempt was recorded as a separate attempt.

  During procedure

Secondary Outcomes (1)

• The Number of Attempts

  During procedure

Other Outcomes (1)

• Procedure-Related Complications

  within the emergency department stay (up to 4 hours after procedure)

Study Arms (2)

Ultrasound-Guided Radial Artery Puncture

EXPERIMENTAL

Participants undergo radial artery puncture for arterial blood gas sampling using real-time ultrasound guidance.

Procedure: Ultrasound-guided radial arterial puncture for arterial blood gas sampling

Conventional Palpation-Guided Radial Artery Puncture

EXPERIMENTAL

Participants undergo radial artery puncture for arterial blood gas sampling using the conventional palpation technique, which represents the standard practice.

Procedure: Conventional radial artery puncture for arterial blood gas sampling

Interventions

Ultrasound-guided radial arterial puncture for arterial blood gas sampling PROCEDURE

Radial artery puncture for arterial blood gas sampling performed under real-time ultrasound guidance. The artery is visualized on the screen and the needle is advanced under direct visualization until arterial blood flow is obtained.

Ultrasound-Guided Radial Artery Puncture

Conventional radial artery puncture for arterial blood gas sampling PROCEDURE

Radial artery puncture for arterial blood gas sampling performed using the conventional palpation technique. The artery is identified by manual palpation and the needle is advanced until arterial blood flow is obtained.

Conventional Palpation-Guided Radial Artery Puncture

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged 18 years and older
• Patients diagnosed with shock
• Patients with an indication for arterial blood gas analysis due to respiratory or metabolic disorders
• Patients who provided written informed consent, either personally or through their legal representatives.

You may not qualify if:

• Patients who declined to participate
• Patients presenting with cardiac arrest
• Patients with a positive Allen test
• Patients with a history of coagulopathy
• Patients with evidence of infection at the puncture site
• Patients with evidence of trauma at the puncture site
• Patients with an arteriovenous fistula at the puncture site

Sponsors & Collaborators

• Ismail Erkan Aydin: lead

Study Sites (1)

Alanya Alaaddin Keykubat University Hospital

Alanya, Antalya, 07400, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Shock; Emergencies

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Disease Attributes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Model Details: This is a single-center, prospective, randomized controlled trial. Patients were randomized in a 1:1 ratio into two groups using an online randomization tool. In the US group, arterial blood gas sampling was performed via radial artery puncture under real-time US guidance. In the non-US group, arterial blood gas sampling was performed using the conventional palpation technique.

Study Record Dates

• First Submitted: January 9, 2026
• First Posted: January 23, 2026
• Study Start: October 1, 2024
• Primary Completion: March 31, 2025
• Study Completion: March 31, 2025
• Last Updated: January 23, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP

Locations

TU (1)