Influence of DM on Artery Blood Flow and Complications After Radial Artery Cannulation

Study Overview
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Brief Summary
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In atherosclerotic patients undergoing kidney transplantation, arterial cannulation is commonly performed for continuous monitoring of systemic blood pressure and intermittent assessment of arterial blood gases. The radial artery is the preferred artery, because of its well-documented low complication rate and easy access, but, radial artery cannulation is may associated with complications. Atherosclerosis is a systemic phenomenon, and structural changes attributable to atherosclerosis, such as luminal narrowing, intimal hyperplasia, and reduction in distensibility occur frequently throughout the arterial tree. Especially in patients with diabetes mellitus (DM), the radial artery is prone to atherosclerosis and perhaps calcification. In a recent study, it was found that the radial artery flow was decreased immediately after cannulation, but recovered to its pre-cannulation value after 5min, whereas a compensatory increase of blood flow in the ulnar artery occured immediately after cannulation, persisting until 5 min. This study enrolled the patients of ASA physical status 1-2. In the patients scheduled for elective kidney transplantation, this compensatory increase of blood flow in the ulnar artery may not be occurred, because of atherosclerosis, particularly in patients with DM. In our study, we found whether there is appropriate compensatory increase of blood flow in the ulnar artery after the radial artery cannulation in two groups, patients with DM (group DM) or without DM (group nonDM), both undergoing elective kidney transplantation.

Conditions
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End Stage Renal Disease

Intervention / Treatment
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* Device: duplex Doppler ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 20yrs undergoing kidney transplantation ASA physical status ≥ 3 patients with DM (DM group), patients without DM (nonDM group) Exclusion Criteria: coagulopathy inflammation or infection at the puncture site for cannulation a positive result on the modified Allen's test the cannulation failed twice Acute renal allograft rejection

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: DM kidney transplantation<br>patient with DM undergoing undergoing kidney transplantation | Device: duplex Doppler ultrasonography<br> <br> |
| Active Comparator: without DM undergoing kidney transplantation<br>patient without DM undergoing undergoing kidney transplantation | Device: duplex Doppler ultrasonography<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the compensatory changes in ulnar artery blood flow after radial artery cannulation | to evaluate the compensatory changes in ulnar artery blood flow after radial artery cannulation using duplex Doppler ultrasonography at each time point | Change from Baseline in ulnar artery blood before anesthesia, before cannulation, 5 min after cannultion, 20 min after removal of the arterial catheter, 24 hous after cannulation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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diabetes mellitus(DM), radial artery cannulation, artery blood flow, complication, End stage renal disease undergoing kidney transplantation