Application of Ultrasound-guided Peripheral Arterial Puncture in Severe Patients with Coronavirus Disease 2019 Under Three-level Protection

  Objective  To explore the application of ultrasound-guided arterial line placement in severe patients with COVID-19.

  Methods  From February to April 2020, we retrospectively collected and analyzed the clinical data of critical patients with COVID-19 with an indwelling peripheral arterial catheter treated by the medical team of Peking Union Medical College Hospital. Patients with ultrasound-guided peripheral arterial catheterization were taken as the study group, while patients whose arterial catheter was placed by traditional palpation were taken as the control group. The puncture condition and complication rate were compared between the two groups.

  Results  A total of 60 severe patients with COVID-19 who met the inclusion and exclusion criteria were enrolled in this study. There were 30 cases in the study group and 30 cases in the control group. In the study group, the success rate of the first catheterization of the peripheral artery (63.3% vs. 26.7%) and the total puncture success rate (79.43± 25.79)% vs. (53.07±30.21)% were higher than those in the control group (all P < 0.05), the puncture times(1.43±0.56 vs. 2.50±1.28) were less than those of the control group (P < 0.05). The rates of 24-hour disuse (6.7% vs. 30.0%), local hematoma (10.0% vs. 36.7%), occlusion, and tortuous (3.3% vs. 40.0%) in the study group were lower than those in the control group (all P < 0.05).

  Conclusion  Under the three-level protection, ultrasound-guided arterial catheter placement for severe patients with COVID-19 can improve the success rate of catheter placement, reduce puncture times, and reduce the incidence of complications.