Does Radial Artery Cannulation Affect the Perfusion Index(PI) of the Hand in Liver Transplant Operations? (radial artery)

November 5, 2026 updated by: DUYGU DEMİROZ, Inonu University

Does Radial Artery Cannulation Affect the Perfusion Index of the Hand in Liver Transplant?

This randomized controlled trial compared palpation-guided and ultrasound-guided radial artery catheterization in adult liver transplant recipients. The primary outcome was the change in perfusion index (Pi) from baseline after catheterization. Secondary outcomes included first-attempt success, number of skin punctures, procedure time, overall success with the assigned technique, and local complications.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

## DLiver transplantation is associated with major hemodynamic changes, and continuous invasive arterial pressure monitoring is an essential part of perioperative management. The radial artery is the most commonly used site. Repeated punctures and mechanical trauma during catheterization may cause local complications and affect peripheral perfusion. Ultrasound guidance may facilitate catheter placement with fewer punctures.

The perfusion index (Pi), derived from pulse oximetry, is the ratio of the pulsatile to the non-pulsatile optical signal and is used to monitor peripheral perfusion. Because Pi is also influenced by systemic hemodynamics, sympathetic activity, temperature, nociception and drugs, changes in Pi were not interpreted as direct evidence of radial artery vasospasm.

In this prospective, randomized, controlled, two-arm parallel-group trial, adult liver transplant recipients were randomized 1:1 to palpation-guided or ultrasound-guided radial artery catheterization. Randomization used a computer-generated sequence and sequentially numbered, opaque, sealed envelopes prepared by an independent person. The envelope was opened after induction of general anesthesia, once hemodynamic stability was achieved and immediately before catheterization. All procedures were performed by a single anesthesiologist experienced in both techniques, using the same 20-gauge non-guidewire arterial cannula in both groups, preferably on the non-dominant hand after a normal modified Allen test.

In the ultrasound group, a high-frequency linear probe was used with a short-axis out-of-plane approach and dynamic needle tip positioning. Pi was measured continuously with a pulse oximetry sensor placed on the index finger the hand. Pi, heart rate, SpO2, pleth variability index (PVI), SpHb and SpOC were recorded immediately before catheterization (baseline) and immediately after catheterization; Pi was additionally recorded 5 and 10 minutes after catheterization.

The primary outcome was the change in Pi from baseline over time. The primary analysis used a linear mixed-effects model including group, time and the group-by-time interaction to account for repeated measurements. Secondary outcomes were compared with appropriate tests (t test or Mann-Whitney U test; chi-square or Fisher's exact test). Results were reported with effect estimates and 95% confidence intervals; a two-sided p<0.05 was considered statistically significant.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
70

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Contact

Study Contact

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Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adult patients (18 years of age or older) undergoing liver transplantation.
  • Patients eligible for radial artery catheterization as part of perioperative monitoring.
  • Patients who provide informed consent to participate in the study.

Exclusion Criteria:

  • Patients in whom radial artery catheterization is contraindicated.
  • Patients who do not provide informed consent to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Other: Conventional Palpation

Conventional Palpation
Procedure: Conventional Palpation

Radial artery catheterization was performed after induction of general anesthesia, preferably on the non-dominant hand after a normal modified Allen test. The radial pulse was identified by palpation and the artery was cannulated using anatomical landmarks with a 20-gauge non-guidewire arterial cannula, the same cannula used in the ultrasound group. The procedure was limited to a maximum of three skin punctures.
Other: Guided Catheterization

-Radial artery catheterization was performed after induction of general anesthesia using the conventional palpation technique. The radial pulse was identified by palpation and the artery was cannulated using anatomical landmarks with a 20-gauge non-guidewire arterial cannula, limited to a maximum of three skin punctures.
Procedure: Ultrasound-Guided Catheterization

Radial artery catheterization performed under real-time ultrasound guidance using an integrated guidewire arterial cannula system.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Perfusion Index from Baseline Following Radial Artery Catheterization
Time Frame: Perfusion index (Pi) will be measured at baseline, immediately after radial artery catheterization, and at 5 and 10 minutes after the procedure to evaluate changes in peripheral perfusion.

Perfusion index (Pi) will be measured at baseline, immediately after radial artery catheterization, and at 5 and 10 minutes after the procedure to assess changes in peripheral perfusion between the palpation-guided and ultrasound-guided catheterization groups.
Perfusion index (Pi) will be measured at baseline, immediately after radial artery catheterization, and at 5 and 10 minutes after the procedure to evaluate changes in peripheral perfusion.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
First-Attempt Radial Artery Catheterization Success Rate
Time Frame: During the catheterization procedure

The proportion of participants in whom radial artery catheterization is successfully completed on the first skin puncture.
During the catheterization procedure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Inonu University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: duygu demiröz, INONU UNİVERSİTY

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 29, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 10, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 10, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 25, 2023

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 4, 2023

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 11, 2023

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 10, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 5, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • INU-LT-RAC-2026-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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