الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Continuous monitoring of critically ill patients requires invasive and important procedures as arterial puncture. Arterial puncture frequently is done by critical care nurses and respiratory therapists for indicated patients. The first site of choice for arterial puncture is radial artery because of its anatomical location and presence of collateral blood flow to the hand through the ulnar artery.
Radial artery puncture can lead to thrombosis of the distal artery. Because 12% of hands have inadequate collateral flow because of an incomplete palmar arch, to minimize the risk of permanent ischemic damage to the hand, many experts suggest confirming adequate collateral circulation before puncture. Assessment of hands’ collateral circulation includes Modified Allen’s test, Barbeau test and Doppler studies.
The aim of this study was to compare between the results of MAT and Barbeau test for the assessment of hands’ collateral circulation before arterial puncture among critically ill patients. To achieve this aim, a descriptive research design was used to conduct this study. Which was carried out in general ICUs namely; (unit I, unit II, and unit III) at the Alexandria Main University Hospital (AMUH). A convenience sample of 100 critically ill patients of both sexes who were admitted to the previously mentioned intensive care units was included in this study. Patients with arteriovenous shunt and haemodynamically unstable patients were excluded from this study.
One tool was used to collect data of this study. This tool named: “Hand collateral circulation assessment tool”. This tool was developed by the researcher after extensive review of relevant literature to compare results of two non-invasive methods for the assessment of hand collateral circulation. It consists of three parts.
Part I includes patients’ characteristics such as age, sex, diagnosis, past medical history and current diagnosis. Part II includes Patients’ clinical data and hemodynamic parameters such as heart rate, respiratory rate, mean arterial pressure and body temperature. It’s also includes assessment of upper extremities for peripheral pulse strength, skin color, skin temperature, skin integrity and presence of edema, hemoglobin level and hematocrit level, arterial blood gases variables such as (PaO2), (PaCO2) and pH level. Part III: Documentation of both Modified Allen’s and Barbeau test results. Modified Allen’s test was documented as Positive MAT, if the hand flushed within five to ten seconds after release of pressure from ulnar artery. Negative MAT, if the hand didn’t flush within five to ten seconds after release of pressure from ulnar artery. Barbeau test was recorded for the same patient according to pulse oximetery waveform with clamp of pulse oximetery applied to thumb. After occlusion of radial artery for two minutes, Barbeau test was considered positive if there was no loss of pulse oximetery waveform, and negative if there was loss of pulse oximetery waveform.
The results of the current study revealed that the age of the studied patients, it was
ranging between 18 and 65 years with a mean age of 52.00 ± 13.16, nearly half of them
(46%) were male, while more than half of them (54%) were females.