Local Warming Technique for Arterial Cannulation in Adult Patients

Study Overview
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Brief Summary
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Based on the fact that arterial vasodilation can be advantageous for endovascular catheterization and that an increase in body temperature can cause vasodilation by activating the cholinergic active vasodilator system, this study was planned to observe whether there was a significant change in the diameter of artery through ultrasound and to confirm the effectiveness of heating in the traditional palpation technique and the US-guided technique after local warming of the insertion site of arterial catheter in adult patients undergoing cardiac surgery.

Detailed Description
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Arterial cannulation is one of the important clinical techniques commonly used for real-time monitoring of blood pressure changes or when repeated blood tests are required. However, complications such as bleeding, hematoma, and vascular occlusion may occur if the operator has little or no experience in the procedure, or if arterial cannulation is not easy due to the patient's underlying disease and systemic factors. This situation prolongs the anesthesia induction time and may cause great harm to the patient in cases with a high bleeding tendency, such as in cardiac surgery. Various studies have reported various arterial cannulation techniques so far, and there have been many advances in arterial cannulation techniques due to the general use of ultrasound (hereafter US). However, there is still a risk of complications due to inexperience in the use of US or poor vascular status of the patient.

Official Title
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Local Warming Technique for Arterial Cannulation in Adult Patients Under Heart Surgery-A Randomized Controlled Trial

Conditions
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Cardiac Disease Which Should be Treated by Surgery

Intervention / Treatment
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* Procedure: warming to increase local skin (puncture site) temperature


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients over 18 years of age undergoing cardiac surgery under general anesthesia Exclusion Criteria: If the patient already has an arterial catheter and does not need additional arterial cannulation. When arterial cannulation is performed on an artery other than the radial artery due to the surgical technique or the patient's condition. When the patient's condition is urgent, such as emergency surgery, and there is no time to proceed with the research.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: non-warming group<br> | |
| Active Comparator: warming group<br> | Procedure: warming to increase local skin (puncture site) temperature<br>* According to the group of participants, investigator applies the warmer to the hands and wrists of the participants, makes a local temperature of 40℃ gradually, and maintains it for about 10 minutes in warming group (which is divided in to warming-palpation (WP) and warming-US (WU) group).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes of the diameter of the artery | Investigator measures where there is a significant increase in the diameter of the artery due to warming using US. | from time point of warming to success of arterial cannulation (the day of surgery, up to 1hour) | 
| changes of the cross-sectional area of the artery | Investigator measures where there is a significant increase in the cross-sectional area of the artery due to warming using US. | from time point of warming to success of arterial cannulation (the day of surgery, up to 1hour) | 
| Success rate of first trial for arterial cannulation | Investigator measures success rate of first trial for arterial cannulation. | from time point of warming to success of arterial cannulation (the day of surgery, up to 1hour) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications related with arterial cannulation | Investigator measures where there are complications such as hematoma, vasopasm, and ischemia. | from time point of warming to success of arterial cannulation (the day of surgery, up to 1hour) |