Comparison between transmural puncture combined with sensor tube technique with direct puncture in invasive blood pressure monitoring: a randomized controlled trial

This study primarily aimed to compare the efficacy of the transmural puncture combined with sensor tube technique and the direct puncture technique by examining the success of radial artery cannulation performed by nurses. The study was a prospective randomized controlled study. A total of 8 neurocritical nurses performed radial arterial insertion for 91 patients using both the transmural puncture combined with sensor tube technique and the direct puncture technique in random order. The primary outcome was successful cannulation of the radial artery in 3 or less attempts. Other collected data included the total number of attempts, total time for catheter cannulation, and occurrence of complications. In comparison with the direct puncture technique, transmural puncture combined with sensor tube increased the probability of successful initial catheterization (OR 3.27, [95% CI: 1.292-8.299]; P = 0.012) and demonstrated less blood exposure (6.52% vs. 80.0%, P < 0.001, φ=-0.742). A combination of transmural puncture and a sensor tube resulted in fewer cases of extubation due to complications. Furthermore, immediate complications caused by puncture (4.34% vs. 17.78%; P = 0.039, φ=-0.215) and extubation due to complications were reduced (47.8% vs. 71.1%, P = 0.024, φ = 0.237). Transmural puncture combined with sensor tube was demonstrated to increase the success rate of the initial arterial puncture, reduce blood exposure and reduce the occurrence of complications. Therefore, the transmural puncture combined with sensor tube technique may be an acceptable option for cannulation of the radial artery.