Document Detail

Ultrasound evidence of the optimal wrist position for radial artery cannulation.
MedLine Citation:
PMID:  19396505     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Radial artery cannulation is a common medical procedure for anesthesia and critical care. To establish the ideal wrist position for radial artery cannulation, we performed ultrasound examinations of the radial artery to investigate the effect of the angle of wrist extension on radial artery dimensions. CLINICAL FEATURES: Measurements were performed in 17 healthy subjects and 17 surgical patients scheduled for coronary artery bypass graft (CABG) surgery. The radial artery was echographically visualized near the styloid process of the radius at the wrist. Radial artery dimensions were measured at wrist joint angles of 0, 15, 30, 45, 60 and 75 degrees . OBSERVATIONS: In both groups, radial artery height was affected by the wrist joint angle. Vessel height was decreased at 60 degrees (one way ANOVA P = 0.027 vs 0 degrees ) and 75 degrees (P < 0.001 vs 0, 15, 45 degrees ) in healthy subject and at 75 degrees in CABG patients (P < 0.001 vs 0 degrees ). The mean differences in radial artery height at 0 and 75 degrees were 0.33 +/- 0.09 mm and 0.20 +/- 0.06 mm for healthy and CABG patients, respectively. Vessel width was not affected by wrist joint angulation up to 75 degrees of extension. CONCLUSION: Our results demonstrate that in healthy subjects, radial artery dimensions are unaltered when the wrist joint is extended up to an angle of 45 degrees . Extension at 60 degrees for healthy subjects and 75 degrees for CABG patients, however, results in a decrease in the height of the radial artery, which could possibly render arterial catheterization more difficult.
Keiko Mizukoshi; Masayuki Shibasaki; Fumimasa Amaya; Takahiro Hirayama; Fumihiro Shimizu; Koji Hosokawa; Satoru Hashimoto; Yoshifumi Tanaka
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-04-25
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  56     ISSN:  1496-8975     ISO Abbreviation:  Can J Anaesth     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-11     Completed Date:  2009-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  427-31     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, Kyoto, 602-8566, Japan.
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MeSH Terms
Aged, 80 and over
Anthropometry / instrumentation*,  methods
Arthrometry, Articular
Coronary Artery Bypass
Middle Aged
Radial Artery / anatomy & histology,  ultrasonography*
Treatment Outcome
Ultrasonography, Interventional
Wrist* / blood supply
Young Adult

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