Guidewire-assisted Radial A-line in Neonate and Infant

Study Overview
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Brief Summary
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In neonate and infant, radial artery cannulation may be challenging and multiple attempts are required because of the small diameter. The invastigators will compare the success rates of radial arterial cannulation with a guidewire-assisted technique and the direct technique in pediatric patient(<1yr).

Official Title
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Comparison of Radial Artery Cannulation Technique in Pediatric Patients: Direct Versus Guidewire-assisted

Conditions
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Arterial Line

Intervention / Treatment
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* Procedure: Guidewire-assist
* Procedure: Direct


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pediatric patients undergoing general anesthesia with arterial cannulation (for hemodynamic monitoring or blood sampling) Exclusion Criteria: Skin lesion, infection, hematoma, recent cannulation at cannulation site Unstable radial pulse (d/t unstable vital sign, or arrhythmias)

Ages Eligible for Study
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Maximum Age: 1 Year

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Guidewire<br>Radial artery puncture with direct radial pulse palpation. 24G angiocatheter insertion with guidewire-assist. (Catheter over guidewire) | Procedure: Guidewire-assist<br>* catheter insertion with guidewire-assist(catheter over guidewire)<br>|
| Active Comparator: Direct<br>Radial artery puncture with direct radial pulse palpation. 24G angiocatheter insertion without guidewire-assist. (Catheter over needle) | Procedure: Direct<br>* catheter insertion without guidewire assist(catheter over needle)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| success rate at 1st attempt (%) | successful catheter insertion after obtaining 1st blood flush in angiocatheter. | from arterial cannulation to successful invasive BP monitoring (up to 1 hour) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total elapsed time (seconds) | total time for successful cannulation. | from arterial cannulation to successful invasive BP monitoring (up to 1 hour) | 
| number of total cannulation attempts (number) | number of total attempts until successful cannulation. (1 attempt = 1 blood flush) | from arterial cannulation to successful invasive BP monitoring (up to 1 hour) | 
| number of total catheter used (number) | number of total catheter used until successful cannulation. | from arterial cannulation to successful invasive BP monitoring (up to 1 hour) | 
| malfunction of arterial line | pressure monitoring, blood sampling | from the start of invasive BP monitoring until the end of anesthesia (up to 1 day) | 
| complications | hematoma, ischemia | from the arterial cannulation until the end of anesthesia (up to 1 day) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Radial Artery, Vascular Catheters