+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children: A randomised controlled trial



Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children: A randomised controlled trial



European Journal of Anaesthesiology 33(7): 522-527



Even with ultrasound guidance, arterial cannulation in children can be challenging. To compare the short-axis/out-of-plane (SAX) with the long-axis/in-plane (LAX) technique for ultrasound-guided arterial cannulation in children. A randomised controlled trial. A tertiary university hospital, from 5 January 2015 to 21 April 2015. 101 children, American Society of Anesthesiologists' physical status 1 or 2 and younger than 5 years of age. All were randomised into one of four groups according to age and ultrasound guidance technique: infants with SAX technique (n = 25), infants with LAX technique (n = 25), children with SAX technique (n = 25) and children with LAX technique (n = 26). Ultrasound-guided arterial cannulation was performed under general anaesthesia via the radial or posterior tibial artery, depending on individual position and operative field. The primary outcome was the total time to successful cannulation. Secondary outcomes included diameter and depth of the artery, time variables (imaging time, time to first successful puncture and time between first successful puncture and cannulation), number of puncture attempts, success rates (first puncture and final cannulation), posterior wall puncture rate and complications. Ultrasound-guided arterial cannulation was successful in 97 children (96.0%). There were no significant differences in the total time to successful cannulation between the two groups. Ultrasound imaging time was significantly longer in the LAX group than in the SAX group (46.5 ± 39.2 vs 16.0 ± 17.6 s; 95% confidence interval of mean difference, -42.7 to -18.3; P = 0.000). However, the posterior wall puncture rate was significantly higher in the SAX group than in the LAX group (95.7% vs 18.0%; P = 0.000; odds ratio 0.01; 95% confidence interval, 0.002 to 0.048). There were no statistically significant differences in other secondary outcomes. Despite the longer imaging time with the LAX approach, there was no significant difference in the total time to successful cannulation between the two techniques. The posterior wall puncture rate was lower in the LAX group than in the SAX group. Clinicaltrials.gov (identifier: NCT02333786).

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058846286

Download citation: RISBibTeXText

PMID: 26986774

DOI: 10.1097/eja.0000000000000453


Related references

Comparison of short-axis out-of-plane versus long-axis in-plane ultrasound-guided radial arterial cannulation in adult patients: a randomized controlled trial. Journal of Anesthesia 31(1): 89-94, 2017

Ultrasound-guided radial arterial cannulation: long axis/in-plane versus short axis/out-of-plane approaches?. Journal of Clinical Monitoring and Computing 27(3): 319-324, 2013

Modified short-axis out-of-plane ultrasound versus conventional long-axis in-plane ultrasound to guide radial artery cannulation: a randomized controlled trial. Anesthesia and Analgesia 119(1): 163-169, 2014

Comparison between the long-axis/in-plane and short-axis/out-of-plane approaches for ultrasound-guided vascular catheterization: an updated meta-analysis and trial sequential analysis. Therapeutics and Clinical Risk Management 14: 331-340, 2018

Ultrasound guided internal jugular vein cannulation in infants: Comparative evaluation of novel modified short axis out of plane approach with conventional short axis out of plane approach. Indian Journal of Anaesthesia 62(3): 208-213, 2018

Effects of long axis in-plane vs short axis out-of-plane techniques during ultrasound-guided vascular access. American Journal of Emergency Medicine 34(5): 778-783, 2016

"Modified Dynamic Needle Tip Positioning" Short-Axis, Out-of-Plane, Ultrasound-Guided Radial Artery Cannulation in Neonates: A Randomized Controlled Trial. Anesthesia and Analgesia 129(1): 178-183, 2019

Comparing Combined Short-Axis and Long-Axis Ultrasound-Guided Central Venous Catheterization With Conventional Short-Axis Out-of-Plane Approaches. Journal of Cardiothoracic and Vascular Anesthesia 33(4): 1029-1034, 2019

Long versus short axis ultrasound guided approach for internal jugular vein cannulation: a prospective randomised controlled trial. Medical Ultrasonography 13(1): 21-25, 2011

A randomized comparison of long-axis and short-axis imaging for in-plane ultrasound-guided popliteal-sciatic perineural catheter insertion. Journal of Anesthesia 28(6): 854-860, 2014

Dynamic ultrasound-guided, short axis, out-of-plane radial artery cannulation: the 'follow the tip' technique. Anaesthesia and Intensive Care 41(3): 431-432, 2013

A randomized clinical trial of ultrasound-guided infra-clavicular cannulation of the subclavian vein in cardiac surgical patients: short-axis versus long-axis approach. Intensive Care Medicine 43(11): 1594-1601, 2017

Ultrasound-guided small vessel cannulation: long-axis approach is equivalent to short-axis in novice sonographers experienced with landmark-based cannulation. Western Journal of Emergency Medicine 15(7): 824-830, 2014

Discussion on "A randomized clinical trial of ultrasound-guided infra-clavicular cannulation of the subclavian vein in cardiac surgical patients: short-axis versus long-axis approach". Intensive Care Medicine 43(8): 1169-1170, 2017

Long-Axis Versus Short-Axis View of Ultrasound-Guided Central Venous Cannulation. Critical Care Medicine 43(12): E597, 2015