May 9, 2019

Line placement better with ultrasound

Using ultrasound to place arterial lines reduces the need for surgical access and improves arterial line location, Vanderbilt researchers have found.

In pediatric cardiac surgery, arterial catheterization is essential for blood pressure monitoring and blood sampling. A thin tube is inserted in the radial artery, which is in the forearm. When palpation technique fails for placement of these lines, surgical vascular cutdown is used, posing risk of infection, among other drawbacks.

Using ultrasound makes for more trouble-free placement of central venous lines, but research on ultrasound’s use with arterial lines is comparatively slight and inconclusive.

For an upcoming study in the Journal of Cardiothoracic and Vascular Anesthesia, Genevieve Staudt, MD, and colleagues reviewed records of 3,569 infants and children who received arterial catheterization in the operating room in connection with congenital heart surgery. In this largest of such studies to date, ultrasound was used in 58% of cases.

Ultrasound was associated with a marked decrease in the need for surgical access, from 10.4% to 1.7% of cases, and with improvement in optimal arterial line location, from 74% to 91%.

Staudt was joined in the study by Susan Eagle, MD, Alexander Hughes, MD, and Brian Donahue, MD, PhD.