Retrospective Observational Single-Center Study of Complications of Arterial Indwelling Catheters for Invasive Blood Pressure in Intensive Care Unit Patients

Abstract

This study aimed to analyze the incidence of complications resulting from the use of an indwelling arterial catheter (IAC). We compared the characteristics of the patients with an IAC who developed complications with those who did not present any complications. The study included 1,869 patients with an IAC hospitalized in intensive care units (ICUs) between 2017 and 2018. Most patients were male (58.7%), in the seventh decade of life, and had systemic arterial hypertension. The most common site of IAC implantation was the radial artery. Fifty-four (2.88%) cases of complications related to an IAC were identified including bleeding, hematomas, and thrombosis. Female patients had a higher risk of complications (P = .030). Comorbidities such as arrhythmias (P < .001) and peripheral arterial disease (P = .041) also increased that risk. The use of vasoactive drugs (P = .001), hemodialysis (P = .001), and orotracheal intubation (OTI) (P = .001) was significantly associated with the occurrence of complications as well as length of stay in ICUs (P < .001) and IAC duration (P = .001). IACs are safe devices commonly used in ICUs, with an incidence of complications of 2.88%.

Keywords

indwelling arterial catheters invasive blood pressure measurement blood pressure complication catheter complication

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References

Garland

Connors

. Indwelling arterial catheters in the intensive care unit: necessary and beneficial, or a harmful crutch?. Am J Respir Crit Care Med 2010; 182: 133–134.

Scheer

Perel

Pfeiffer

. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care 2002; 6: 199–204

Martin

Saux

Papazian

, et al. Long-term arterial cannulation in ICU patients using the radial artery or dorsalis pedis artery. Chest 2001; 119: 901–906.

Thomas

Burke

Parker

, et al. The risk of infection related to radial vs femoral sites for arterial catheterization. Crit Care Med 1983; 11: 807–812.

Davis

Stewart

. Radial artery cannulation. A prospective study in patients undergoing cardiothoracic surgery. Br J Anaesth 1980; 52: 41–47.

Garland

. Arterial lines in the ICU: a call for rigorous controlled trials. Chest 2014; 146: 1155–1158.

Frezza

Mezghebe

. Indications and complications of arterial catheter use in surgical or medical intensive care units: analysis of 4932 patients. Am Surg 1998; 64: 127–131

Dorman

Breslow

Lipsett

, et al. Radial artery pressure monitoring underestimates central arterial pressure during vasopressor therapy in critically ill surgical patients. Crit Care Med 1998; 26: 1646–1649.

Cannon

Meshier

. Extremity amputation following radial artery cannulation in a patient with hyperlipoproteinemia type V. Anesthesiology 1982; 56: 222–223.

10.

Hausmann

Schulteam Esch

Fischdick

. Radial artery cannulation: a prospective study on its complication rate by clinical and sonographic evaluation [in German]. Anasth Intensivther Notfallmed 1981; 16: 269–273.

11.

Mangar

Laborde

. Delayed ischaemia of the hand necessitating amputation after radial artery cannulation. Can J Anaesth 1993; 40: 247–250

12.

Durie

Beckmann

Gillies

. Incidents relating to arterial cannulation as identified in 7,525 reports submitted to the Australian incident monitoring study (AIMS-ICU). Anaesth Intensive Care 2002; 30: 60–65.

13.

Bedford

. Wrist circumference predicts the risk of radial-arterial occlusion after cannulation. Anesthesiology 1978; 48: 377–378