Results: A total of 113 children were included in the analysis. The nitroglycerin group had a higher first-attempt success rate than the control group (91.2% [52 of 57] vs. 66.1% [37 of 56]; P = 0.002; odds ratio, 5.3; 95% CI, 1.83 to 15.6; absolute risk reduction, –25.2%; 95% CI, –39.6 to –10.7%). Subcutaneous nitroglycerin injection increased the diameter of the radial artery greater than normal saline (25.0 ± 19.5% vs. 1.9 ± 13.1%; 95% CI of mean difference, 16.9 to 29.3%; P < 0.001). Overall complication rate was lower in the nitroglycerin group than in the control group (3.5% [2 of 57] vs. 31.2% [18 of 56]; P = 0.001; odds ratio, 0.077; 95% CI, 0.017 to 0.350; absolute risk reduction, 28.6%; 95% CI, 15.5 to 41.8%).
Conclusions: Subcutaneous nitroglycerin injection before radial artery cannulation improved the first-attempt success rate and reduced the overall complication rates in pediatric patients.
Editor’s Perspective:
What We Already Know about This Topic:
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Radial artery cannulation in infants can be technically challenging
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In adult patients, nitroglycerin has been found to facilitate radial artery cannulation
What This Article Tells Us That Is New:
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In children less than 2 yr of age, infiltration around the radial artery with 5 mcg/kg of nitroglycerin in 0.5 ml of saline increased the first success rate of arterial cannulation
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