Eficácia da ultrassonografia em tempo real na punção de artérias de pacientes pediátricos: uma revisão sistemática
DOI:
https://doi.org/10.11606/issn.1679-9836.v103i3e-224102Palavras-chave:
Cateterismo Arterial Periférico, Ultrassonografia, Pediatria, Anestesiologia, Terapia IntensivaResumo
Introdução: Convencionalmente, o acesso arterial periférico acontece através da técnica palpatória com inserção de cateter a partir da sensação do pulso arterial. Em crianças pequenas, esse acesso é mais difícil que em adultos devido ao menor tamanho das artérias, o que torna o procedimento mais desafiador. Assim, a ultrassonografia em tempo real vem positivamente auxiliando o acesso arterial em pacientes pediátricos. Objetivos: Avaliar a eficácia da punção arterial guiada por ultrassom em diferentes sítios e identificar os perfis de pacientes beneficiados por essa técnica através dos desfechos de sucesso na primeira tentativa, sucesso total e intercorrências. Metodologia: Foi conduzida uma revisão sistemática com dados coletados nas bases PubMed, Embase, Cochrane CENTRAL e Scopus pelos termos “Infant, Newborn”, “Infant”, “Child, Preschool”, “Child”, “Adolescent”, “Catheterization, Peripheral”, “Ultrasonography” e seus equivalentes. Desfechos de sucesso na primeira tentativa (primário), sucesso total e intercorrências foram procurados em ensaios clínicos randomizados que compararam punção arterial guiada por ultrassom com a técnica palpatória. Resultados: Sete ensaios clínicos randomizados obedeceram aos critérios de inclusão e demonstraram diferentes riscos de viés. As artérias analisadas foram: radial, femoral, tibial posterior e pediosa dorsal. Os ensaios envolveram 675 pacientes entre neonatos, lactentes, pré-escolares, crianças e adolescentes. Na artéria radial, o ultrassom aumentou o sucesso na primeira tentativa e o sucesso total, além de ter diminuído a incidência de hematomas. Na artéria femoral, o ultrassom aumentou o sucesso na primeira tentativa. Nas artérias tibial posterior e pediosa dorsal, o ultrassom aumentou o sucesso na primeira tentativa e o sucesso total. Conclusões: Em consonância com revisões passadas, o ultrassom demonstrou eficácia para melhorar os desfechos da punção arterial em diferentes sítios e pacientes, principalmente na artéria radial. Visando oferecer um melhor cuidado, o treinamento em punção arterial guiada por ultrassom é uma estratégia que pode ser adotada por universidades e serviços de saúde.
Downloads
Referências
Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care. 2002;6(3):199-204. Doi: https://doi.org/10.1186/cc1489
Maini S. Radial and Femoral Artery Catheterization Techniques. Atlas Oral Maxillofac Surg Clin. 2015;23(2):159-63. Doi: http://dx.doi.org/10.1016/j.cxom.2015.05.007
Aouad-Maroun M, Raphael CK, Sayyid SK, Farah F, Akl EA. Ultrasound-guided arterial cannulation for paediatrics. Cochrane Database Syst Rev. 2016;(9):. Doi: https://doi.org/10.1002/14651858.CD011364.pub2
Mehran R, Pocock S, Nikolsky E, Dangas GD, Clayton T, Claessen BE, et al. Impact of bleeding on mortality after percutaneous coronary intervention: Results from a patient-level pooled analysis of the REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events), ACUITY (Acute Catheterization and Urgent In. JACC Cardiovasc Interv. 2011;4(6):654-64. Doi: https://doi.org/10.1016/j.jcin.2011.02.011
Sartorius B, Behnes M, Ünsal M, Hoffmann U, Lang S, Mashayekhi K, et al. Arterial access-site complications after use of a vascular closure device related to puncture height. BMC Cardiovasc Disord. 2017;17(1):64. Doi: https://doi.org/10.1186/s12872-017-0484-7
Mortensen J, Talbot S, Burkart JA. Cross-sectional internal diameters of human cervical and femoral blood vessels: Relationship to subject’s sex, age, body size. Anat Rec. 1990;226(1):115-24. Doi: https://doi.org/10.1002/ar.1092260114
Lau CSM, Chamberlain RS. Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis. Pediatr Res. 2016;80(2):178-84. Doi: https://doi.org/10.1038/pr.2016.74
Sobolev M, Shiloh AL, Di Biase L, Slovut DP. Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: A systematic review and meta-analysis. Europace. 2017;19(5):850-5. Doi: https://doi.org/10.1093/europace/euw113
Zhang W, Li K, Xu H, Luo D, Ji C, Yang K, et al. Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials. Crit Care. 2020;24(1):197. Doi: https://doi.org/10.1186/s13054-020-02920-8
Gu WJ, Tie HT, Liu JC, Zeng XT. Efficacy of ultrasound-guided radial artery catheterization: A systematic review and meta-analysis of randomized controlled trials. Crit Care. 2014;18(3). Doi: https://doi.org/10.1186/cc13862
Liberati A. The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. Ann Intern Med. 2009;151(4):W-65-W94. Doi: https://doi.org/10.7326/0003-4819-151-4-200908180-00136
Saenger ALF, Caldas CP, Motta LB. Adaptação transcultural para o Brasil do instrumento PRISMA-7: avaliação das equivalências conceitual, de item e semântica. Cad Saude Publica. 2016;32(9):e00072015. Doi: https://doi.org/10.1590/0102-311X00072015
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):1-10. Doi: http://dx.doi.org/10.1186/s13643-016-0384-4
Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869–c869. Doi: https://doi.org/10.1136/bmj.c869
Higgins JP, Savović J, Page MJ, Sterne JAC. RoB 2 Guidance: Parallel Trial [Internet]. The Cochrane Collaboration. 2019. p. 1-24. https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials
Schwemmer U, Arzet HA, Trautner H, Rauch S, Roewer N, Greim CA. Ultrasound-guided arterial cannulation in infants improves success rate. Eur J Anaesthesiol. 2006;23(6):476-80. Doi: https://doi.org/10.1017/S0265021506000275
Anantasit N, Cheeptinnakorntaworn P, Khositseth A, Lertbunrian R, Chantra M. Ultrasound Versus Traditional Palpation to Guide Radial Artery Cannulation in Critically Ill Children: A Randomized Trial: A. J Ultrasound Med. 2017;36(12):2495-501. Doi: https://doi.org/doi:10.1002/jum.14291
Ganesh A, Kaye R, Cahill AM, Stern W, Pachikara R, Gallagher PR, et al. Evaluation of ultrasound-guided radial artery cannulation in children. Pediatr Crit Care Med. 2009;10(1):45-8. Doi: https://doi.org/10.1097/PCC.0b013e31819368ca
Takeshita J, Tachibana K, Nakayama Y, Nakajima Y, Hamaba H, Yamashita T, et al. Ultrasound-guided dynamic needle tip positioning versus conventional palpation approach for catheterisation of posterior tibial or dorsalis pedis artery in infants and small children. Br J Anaesth. 2021;126(4):e140-2. Doi: https://doi.org/10.1016/j.bja.2020.11.033
Ishii S, Shime N, Shibasaki M, Sawa T. Ultrasound-guided radial artery catheterization in infants and small children. Pediatr Crit care Med a J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2013;14(5):471-3. Doi: https://doi.org/10.1097/PCC.0b013e31828a8657
Liu L, Tan Y, Li S, Tian J. “Modified Dynamic Needle Tip Positioning” Short-Axis, Out-of-Plane, Ultrasound-Guided Radial Artery Cannulation in Neonates: A Randomized Controlled Trial. Anesth Analg. 2019;129(1):178-83. Doi: https://doi.org/10.1213/ANE.0000000000003445
Min JJ, Tay CK, Gil NS, Lee JH, Kim S, Kim CS, et al. Ultrasound-guided vs. palpation-guided techniques for radial arterial catheterisation in infants: A randomised controlled trial. Eur J Anaesthesiol. 2019;36(3):200-5. Doi: https://doi.org/10.1097/EJA.0000000000000926
Siddik-Sayyid SM, Aouad MT, Ibrahim MH, Taha SK, Nawfal MF, Tfaili YJ, et al. Femoral arterial cannulation performed by residents: a comparison between ultrasound-guided and palpation technique in infants and children undergoing cardiac surgery. Ramamoorthy C, editor. Pediatr Anesth. 2016;26(8):823-30. Doi: https://doi.org/10.1111/pan.12935
Ali S, Athar M, Ahmed SM. Vascular access in children. Indian J Anaesth. 2019;63(9):737-45. Doi: https://doi.org/10.4103/ija.IJA_489_19
Bhattacharjee S, Maitra S, Baidya DK. Comparison between ultrasound guided technique and digital palpation technique for radial artery cannulation in adult patients: An updated meta-analysis of randomized controlled trials. J Clin Anesth. 2018;47:54-9. Doi: https://doi.org/10.1016/j.jclinane.2018.03.019
Seto AH, Roberts JS, Abu-Fadel MS, Czak SJ, Latif F, Jain SP, et al. Real-time ultrasound guidance facilitates transradial access: RAUST (Radial Artery Access with Ultrasound Trial). JACC Cardiovasc Interv. 2015;8(2):283-91. Doi: https://doi.org/10.1016/j.jcin.2014.05.036
Gopalasingam N, Obad DS, Kristensen BS, Lundgaard P, Veien M, Gjedsted J, et al. Ultrasound-guidance outperforms the palpation technique for peripheral venous catheterisation in anaesthetised toddlers: a randomised study. Acta Anaesthesiol Scand. 2017;61(6):601-8. Doi: https://doi.org/10.1111/aas.12901
Tang L, Wang F, Li Y, Zhao L, Xi H, Guo Z, et al. Ultrasound guidance for radial artery catheterization: An updated meta-analysis of randomized controlled trials. PLoS One. 2014;9(11). Doi: https://doi.org/10.1371/journal.pone.0111527
Heiberg J, Hansen LS, Wemmelund K, Sorensen AH, Ilkjaer C, Cloete E, et al. Point-of-Care Clinical Ultrasound for Medical Students. Ultrasound Int Open. 2015;1(2):E58-66. Doi: http://dx.doi.org/ 10.1055/s-0035-1565173
Rashid MK, Sahami N, Singh K, Winter J, Sheth T, Jolly SS. Ultrasound guidance in femoral artery catheterization: A systematic review and a meta-analysis of randomized controlled trials. J Invasive Cardiol. 2019;31(7):E192-8. https://www.hmpgloballearningnetwork.com/site/jic/articles/ultrasound-guidance-femoral-artery-catheterization-systematic-review-and-meta-analysis-randomized-controlled-trials
Kantor DB, Su E, Milliren CE, Conlon TW. Ultrasound Guidance and Other Determinants of Successful Peripheral Artery Catheterization in Critically Ill Children∗. Pediatr Crit Care Med. 2016;17(12):1124-30. Doi: https:://doi.org/10.1097/PCC.0000000000000936
Oulego-Erroz I, Mayordomo-Colunga J, González-Cortés R, Sánchez-Porras M, Llorente-de la Fuente A, Fernández-de Miguel S, et al. Ultrasound-guided arterial cannulation or by pulse palpation in the intensive care unit. An Pediatría. 2021;94(3):144-52. Doi: https://doi.org/10.1016/j.anpede.2019.12.014
Kleidon TM, Schults J, Paterson R, Rickard CM, Ullman AJ. Comparison of ultrasound-guided peripheral intravenous catheter insertion with landmark technique in paediatric patients: A systematic review and meta-analysis. J Paediatr Child Health. 2022;58(6):953-61. Doi: https://doi.org/10.1111/jpc.15985
Mitchell EO, Jones P, Snelling PJ. Ultrasound for Pediatric Peripheral Intravenous Catheter Insertion: A Systematic Review. Pediatrics. 2022;149(5). Doi: https://doi.org/10.1542/peds.2021-055523
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2024 Salomão Oliveira Rios Meireles Freitas, Natália Lino Dórea, Zilma Verçosa de Sá Ribeiro
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.
