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Evaluation of distal radial artery cross-sectional internal diameter in pediatric patients using ultrasound
Eliane Q S Varga1, Keith A Candiotti, Bruce Saltzman
1Department of Anesthesiology, University of Miami-Miller School of Medicine, Miami, FL 33136, USA. EVarga@med.miami.edu
Insights
Measuring the radial artery internal diameter (RAID) in young children before anesthesia is crucial. This helps prevent difficulties and potential arterial injury during intra-arterial catheter placement.
Area of Science:
- Pediatric Anesthesiology
- Vascular Ultrasound
- Medical Device Safety
Background:
- Intra-arterial catheterization in children requires precise vessel sizing.
- The radial artery internal diameter (RAID) is a key parameter for catheter selection.
- Accurate RAID measurement is essential to avoid complications in pediatric patients.
Purpose of the Study:
- To measure the radial artery internal diameter (RAID) in children up to 4 years of age.
- To assess the reliability of RAID measurements using portable color Doppler ultrasound.
- To determine the clinical relevance of RAID in relation to intra-arterial catheter selection in pediatric anesthesia.
Main Methods:
- Utilized B-mode portable color Doppler ultrasound for RAID measurement.
- Recorded three sets of RAID measurements per child.
- Included measurements before and after anesthesia induction, in neutral and dorsiflexed wrist positions.
- Established reliability in 24 pediatric patients.
Main Results:
- Reliable RAID measurements were established in the study cohort.
- Discrepancies were noted between measured RAID and recommended catheter sizes.
- These discrepancies highlight potential challenges in catheter placement and risk of arterial injury.
Conclusions:
- Measuring the radial artery internal diameter (RAID) in small children before intra-arterial catheter insertion is recommended.
- Accurate pre-procedural RAID assessment can improve catheter placement success.
- This practice may mitigate risks of arterial injury in pediatric patients.
Abstract:
In this study, we measure the radial artery internal diameter (RAID) in children up to 4 years of age before and after the induction of anesthesia. A B-mode portable color Doppler ultrasound was used to measure the RAID. Three sets of measurements were taken for each child before and after the induction of anesthesia and with the wrist in the neutral and dorsiflexed positions. The reliability of the mean value of the RAID in the three sets in 24 patients was established. There were discrepancies between the RAID and the proposed catheter size in some individuals, which may not only render placement difficult but also have potential for arterial injury. There are good reasons to measure the RAID in small children prior to insertion of an intra-arterial catheter.
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