超声引导下左心瓣膜返流性和狭窄性病变患者的桡动脉插管。

IF 1.1 Q3 ANESTHESIOLOGY Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2023-09-01 Epub Date: 2023-06-02 DOI:10.1177/10892532231181481
C M Rakhi Krishna, Sandeep Kumar Mishra, Ajay Kumar Jha, Muthapillai Senthilnathan, Satyen Parida
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引用次数: 1

摘要

背景动脉循环的脉冲特征可能影响桡动脉插管的成功率。因此,我们假设左侧严重狭窄瓣膜病变组的桡动脉插管成功率低于严重反流瓣膜病变组。方法。这项前瞻性研究是在接受心脏和非心脏手术的左侧心瓣膜病变患者中进行的。左侧严重瓣膜狭窄和左侧严重瓣膜反流的患者被纳入研究。桡动脉插管采用超声引导平面外短轴入路。结果指标包括成功率、尝试次数和插管时间。后果152名患者被招募参加这项研究,所有患者都有资格进行最终分析。狭窄瓣膜病变组的首次尝试成功率并不显著高于反流组(69.7%vs 56.6%;P=0.09)。此外,反流组的尝试次数(中位数;95%CI)显著较高(1;1.2-1.43vs 1;1.38-1.67;P=0.04)。然而,这可能与临床无关。此外,插管时间和插管重定向次数是可比较的。反流组的心率明显较高(91.8±13.9 vs 82.26±15.92次/分;P=0.00),而狭窄病变的心房颤动发生率明显较高(P=0.00)。没有失败报告,动脉周围血肿的发生率相当。结论在左侧狭窄瓣膜病变组和反流病变组中,超声引导下桡动脉插管的成功率相当。
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Ultrasound-Guided Radial Arterial Catheterization in Patients With Regurgitant and Stenotic Left-Sided Cardiac Valvular Lesions.

Background. The pulse characteristics of arterial circulation might affect radial artery catheterization's success rate. Therefore, we hypothesized that the success rate of radial artery catheterization would be lower in the left-sided severe stenotic valvular lesion group than severe regurgitant valvular lesion group. Methods. This prospective study was conducted among patients with left-sided cardiac valvular lesions undergoing cardiac and non-cardiac surgery. The patients with left-sided severe valvular stenosis and left-sided severe valvular regurgitation were included in the study. Radial artery cannulation was performed using an ultrasound-guided out-of-plane short-axis approach. The outcome measures were success rate, number of attempts, and cannulation time. Result. One hundred fifty-two patients were recruited for the study, and all were eligible for final analysis. The first attempt success rate was non-significantly higher in the stenotic valvular lesion group than the regurgitant group (69.7% vs 56.6%; P = .09). Furthermore, the number of attempts (median; 95% CI) was significantly higher in the regurgitant group (1; 1.2-1.43 vs 1; 1.38-1.67; P = .04). However, it may not be of clinical relevance. Moreover, the cannulation time and the number of redirections of the cannula were comparable. Heart rate was significantly higher in the regurgitant group (91.8 ± 13.9 vs 82.26 ± 15.92 beats/min; P = .00), while the incidence of atrial fibrillation was significantly higher in the stenotic lesion (P = .00). No failure was reported, and the incidence of periarterial hematoma was comparable. Conclusion. The success rate of ultrasound-guided radial arterial catheterization is comparable in left-sided stenotic valvular and regurgitant lesion groups.

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CiteScore
3.60
自引率
14.30%
发文量
31
期刊最新文献
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