ORIGINAL RESEARCH article
Front. Pediatr.
Sec. General Pediatrics and Pediatric Emergency Care
Efficacy and safety of arterial blood gas analysis via distal radial artery in children
Provisionally accepted
Ling Yang1Xiaoting Zhou1Shiting Shu1Heng Ding1Wenjie Mao1Gaojun Cai2Yidong Zhao1Yu Wan1
Zhiying Huang1*- 1Changzhou No.2 People's Hospital, Changzhou, China
- 2Changzhou Wujin People's Hospital, Changning, Jiangsu Province, China
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Objective: The distal transradial approach is widely accepted in adult cardiovascular interventions and invasive arterial blood pressure monitoring. However, limited evidence exists regarding the efficacy and safety of arterial blood gas analysis (ABGA) via the distal radial artery (DRA) in children. Methods: This retrospective study evaluated the efficacy and safety of arterial puncture via the DRA compared with the conventional radial artery (CRA) for ABGA in children. Results: A total of 240 children were allocated to either the DRA group (n = 140) or the CRA group (n = 100). The success rate (82.1% vs. 92.0%, p = 0.029) and one-needle success rate (75.7% vs. 89.0%, p = 0.009) were significantly lower in the DRA group. Puncture time in the DRA group was significantly longer than that in the CRA group, whereas hemostasis time was shorter in the DRA group. The incidences of incorrect venipuncture (11.4% vs. 1.0%, p = 0.002) and thumb numbness (5.7% vs. 0.0%, p = 0.022) in the DRA group were significantly higher than those in the CRA group. However, the incidence of hematoma (modified EASY Ia type) in the DRA group was significantly lower than that in the CRA group (8.6% vs. 50.0%, p ˂ 0.001). No significant differences were observed in the incidences of hemorrhage or radial artery occlusion between the two groups. Conclusion: DRA puncture for ABGA in children appears to be a safe and practical alternative to CRA. Although first-attempt success is slightly lower and training is required, the reduced risk of hematoma and shorter hemostasis time make it a promising option for clinical use.
Keywords: Arterial blood gas analysis, Distal radial artery, Radial Artery, conventional radial artery, Children
Received: 13 Apr 2025; Accepted: 19 Nov 2025.
Copyright: © 2025 Yang, Zhou, Shu, Ding, Mao, Cai, Zhao, Wan and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhiying Huang, hzy982@njmu.edu.cn
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