The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials
Open accessAbstract
Background: The use of an ultrasound-guided technique for radial arterial catheterization has not been well established in pediatric patients. We conducted a systematic review and meta-analysis to evaluate the efficacy of the ultrasound-guided technique for radial artery catheterization in pediatric populations. Method: A systematic review of PubMed, Medline, Embase, and the Cochrane library was performed from their date of inception to December 2019. In this meta-analysis, we conducted online searches using the search terms “ultrasonography,” “ultrasonics,” “ultrasound-guided,” “ultrasound,” “radial artery,” “radial arterial,” “catheter,” “cannula,” and “catheterization.” The rate of the first-attempt and total success, mean attempts to success, mean time to success, and incidence of complications (hematomas) were extracted. Data analysis was performed with RevMan 5.3.5. Results: From 7 relevant studies, 558 radial artery catheterizations were enrolled, including 274 ultrasound-guided and 284 palpation catheterizations. The ultrasound-guided technique could significantly improve the rate of first-attempt and total success (RR 1.78, 95% CI 1.46 to 2.18, P < 0.00001; RR 1.33; 95% CI 1.20 to 1.48; P < 0.00001). However, there was significant heterogeneity for the total success rate among the included studies (I2 = 67%). The ultrasound-guided radial artery catheterization was also associated with less mean attempts and mean time to success (WMD − 1.13, 95% CI − 1.58 to − 0.69; WMD − 72.97 s, 95% CI − 134.41 to − 11.52) and lower incidence of the hematomas (RR 0.17, 95% CI 0.07 to 0.41). Conclusions: The use of the ultrasound-guided technique could improve the success rate of radial arterial catheterization and reduce the incidence of hematomas in pediatric patients. However, the results should be interpreted cautiously due to the heterogeneity among the studies.
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“In pediatrics, both meta-analyses and RCTs have shown higher success rates and fewer complications for US-guided arterial cannulation (typically radial artery) compared to palpation or Doppler guidance [ 3 , 5 ].”
From Ultrasound vessel sizing before cannulation: a measurement-first approach for anesthesiologists (2026) · cites this paper as [3]
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“The evidence compiled in this review indicates higher first-pass success rates, fewer attempts, faster placement times, and reduced complication rates when ultrasound pre-measurement and real-time guidance are used compared to traditional landmark techniques [ 2 – 5 , 13 ].”
From Ultrasound vessel sizing before cannulation: a measurement-first approach for anesthesiologists (2026) · cites this paper as [3]
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“Furthermore, US guidance improves outcomes for peripheral IV (PIV) placement and radial arterial cannulation – including in pediatric patients – compared to landmark techniques [ 2 – 5 ].”
From Ultrasound vessel sizing before cannulation: a measurement-first approach for anesthesiologists (2026) · cites this paper as [3]
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“Furthermore, US guidance improves outcomes for peripheral IV (PIV) placement and radial arterial cannulation – including in pediatric patients – compared to landmark techniques [ 2 – 5 ].”
From Ultrasound vessel sizing before cannulation: a measurement-first approach for anesthesiologists (2026) · cites this paper as [3]
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In the citing paper
“To minimize the risk of arterial spasm or occlusion, we apply the “one-third rule” for catheter size in arteries: limiting the catheter’s outer diameter to approximately one-third of the arterial inner diameter may help reduce the risk of vasospasm and occlusion (equivalently, catheter cross-sectional area ≤ 1/3 of the lumen area, which is OD/ID ≤ 0.577) [ 3 , 6 , 7 ].”
From Ultrasound vessel sizing before cannulation: a measurement-first approach for anesthesiologists (2026) · cites this paper as [3]
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Cites
Guidelines for Performing Ultrasound Guided Vascular Cannulation
Troianos, C. A., Hartman, G. S., Glas, K. E., Skubas, N. J., Eberhardt, R. T., Walker, J. D., & Reeves, S. T. (2011) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e3182407cd8 · Cited by 325
Ultrasound-guided arterial cannulation in infants improves success rate
Schwemmer, U., Arzet, H. A., Trautner, H., Rauch, S., Roewer, N., & Greim, C. A. (2006) · European Journal of Anaesthesiology · doi:10.1017/s0265021506000275 · Cited by 154
Ultrasound-guided arterial cannulation for paediatrics
Aouad-Maroun, M., Raphael, C. K., Sayyid, S. K., Farah, F., & Akl, E. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011364.pub2 · Cited by 147
White, L., Halpin, A., Turner, M., & Wallace, L. (2016) · British Journal of Anaesthesia · doi:10.1093/bja/aew097 · Cited by 142
Catheterization of the radial or brachial artery in neonates and infants
Schindler, E., KOWALD, B., Suess, H., NIEHAUS‐BORQUEZ, B., Tausch, B., & Brecher, A. M. (2005) · Pediatric Anesthesia · doi:10.1111/j.1460-9592.2004.01522.x · Cited by 111
Ultrasound Guidance Facilitates Radial Artery Catheterization
Gu, W.-J., Wu, X.-D., Wang, F., Ma, Z.-L., & Gu, X.-P. (2016) · Chest · doi:10.1378/chest.15-1784 · Cited by 109
Pacha, H. M., Alahdab, F., Al-khadra, Y., Idris, A., Rabbat, F., Darmoch, F., Soud, M., Zaitoun, A., Kaki, A., Rao, S. V., et al. (2018) · American Heart Journal · doi:10.1016/j.ahj.2018.06.007 · Cited by 105
Evaluation of ultrasound-guided radial artery cannulation in children
Ganesh, A., Kaye, R. D., Cahill, A. M., Stern, W., Pachikara, R., Gallagher, P. R., & Watcha, M. F. (2009) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0b013e31819368ca · Cited by 104
Gu, W., Tie, H., Liu, J., & Zeng, X. (2014) · Critical Care · doi:10.1186/cc13862 · Cited by 101
Berk, D., Gürkan, Y., Kuş, A., Ulugöl, H., Solak, M., & Toker, K. (2013) · Journal of Clinical Monitoring and Computing · doi:10.1007/s10877-013-9437-6 · Cited by 96
Research works printed but not linked: 1
- Liu GL, Zheng TH, Lv H. The value of ultrasound guided technique for radial artery catheterization in small children and infants. Chin J Anesthesiol. 2013;33(10):2.
Cited by
Vegas, A., Wells, B. J., Braum, P. F., Denault, A. Y., Miller‐Hance, W. C., Kaufman, C. S., Patel, M. B., & Salvatori, M. (2025) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2024.12.004 · Cited by 83
Martha, J. W., Pranata, R., Wibowo, A., & Lim, M. A. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.02.029 · Cited by 51
Smart Glasses for Radial Arterial Catheterization in Pediatric Patients: A Randomized Clinical Trial
Jang, Y., Cho, S., Ji, S., Kim, E., Lee, J., Kim, H., & Kim, J. (2021) · Anesthesiology · doi:10.1097/aln.0000000000003914 · Cited by 44
Schults, J. A., Young, E., Marsh, N. M., Larsen, E. N., Corley, A., Ware, R. S., Murgo, M., Alexandrou, E., McGrail, M. R., Gowardman, J. R., et al. (2024) · Journal of Intensive Care · doi:10.1186/s40560-024-00719-1 · Cited by 32
Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review
Nakayama, Y., Takeshita, J., Nakajima, Y., & Shime, N. (2020) · Critical Care · doi:10.1186/s13054-020-03305-7 · Cited by 29
Metadata
- Authors
- Zhang, W., Li, K., Xu, H., Luo, D., Ji, C., Yang, K., & Zhao, Q.
- Affiliations
- Liaocheng People's Hospital (CN)
- Corresponding author
- Xu, Hui
- ORCID
- Venue
- Critical Care
- Published
- 2020-05-06
- Volume
- 24
- Issue
- 1
- Pages
- 197-197
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC7201726
- OpenAlex
- W3022139252
- Cited by
- 34
- References
- 31
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 9 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 1
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- creativecommons.org/licenses/by/4.0/ (tdm)
- creativecommons.org/licenses/by/4.0/ (vor)
- Locations
- Critical Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Natural Science Foundation of Shandong Province (ZR2017MH112)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Central Venous Catheters and Hemodialysis
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- ultrasound-guided catheterization, radial artery catheterization, pediatric patients, central venous catheterization, catheterization success rate, vascular access complications
- MeSH terms
- Catheterization, Peripheral, Humans, Pediatrics, Randomized Controlled Trials as Topic, Radial Artery, Ultrasonography, Interventional, Vascular Access Devices
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- Zhang, W., Li, K., Xu, H., Luo, D., Ji, C., Yang, K., & Zhao, Q. (2020). Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials. Critical Care. https://doi.org/10.1186/s13054-020-02920-8
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