Obtaining blood samples from arteries is important in the diagnosis and the monitor-ing of treatment in many medical situations. While arterial puncture by needle is indicated for one or a low number of intermittent samplings, arterial catheterization is indicated for multiple sampling. Both procedures are subject to complications; those associated with catheterization include embolic phenomena, thrombus formation, arterial occlusion, aneurysm formation, arteriovenous fistula, infection, sensory loss, hematoma formation, bleeding, pain, inadvertent injection of drugs, and collection of inaccurate data. These complications may be precipitated by certain catheter mate-rials, by vessel and catheter size, by duration of cannulation, by irrigation, by pre-existing arterial disease, and by low cardiac output. Measures to prevent com-plications include choosing the most distal sites, using Allen's test or a modification thereof, using small diameter, short, Teflon catheters, securing catheters properly, using a continuous, slow infusion of heparinized saline, and not injecting potentially toxic or irritating substances through arterial catheters.
PettyTL, BigelowDB, LevineBE. The simplicity and safety of arterial puncture. JAMA1966;195:181–183.
2.
FlenleyDC. Arterial puncture. Br Med J1980;281:128–131.
3.
NevaiserRJ, AdamsJP, MayGI. Complications of arterial puncture in anticoagulated patients. J Bone Joint Surg1976;58-A:218–220.
4.
WestJB. Pulmonary pathophysiology—The essentials. Baltimore: Williams and Wilkins, 1977:37–39.
5.
BrodskyJB. A simple method to determine patency of the ulnar artery intraoperatively prior to radial-artery cannulation. Anesthesiology1975;42:626–627.
6.
DaltonB, LaverMB. Vasospasm with an indwelling radial artery cannula. Anesthesiology1971;34:194–197.
7.
RichmanKA, JobesDR, SchwalbAJ. Continuous in-vivo blood-gas determination in man: Reliability and safety of a new device. Anesthesiology1980;52:313–317.
8.
WillattsS.How to cannulate a peripheral artery. Br J Hosp Med1980;23:628, 630-631.
ConwayM, DurbinGM, IngramBA, . Continuous monitoring of arterial oxygen tension using a catheter-tip polarographic electrode in infants. Pediatrics1976;57:244–250.
11.
BedfordRF. Percutaneous radial-artery cannulation—Increased safety using Teflon catheters. Anesthesiology1975;42:220–222.
HusumB, PalmT, EriksenJ.Percutaneous cannulation of the dorsalis pedis artery. Br J Anaesth1979;51:1055–1058.
30.
HusumB, PalmT.Before cannulation of the radial artery: Collateral arterial supply evaluated by strain-gauge plethysmography. Acta Anaesthesiol Scand1980;24:412–414.
31.
BartlettRH, MunsterAM. An improved technic for prolonged arterial cannulation. N Engl J Med1968;279:92–93.
32.
BedfordRF. Radial arterial function following percutaneous cannulation with 18- and 20-gauge catheters. Anesthesiology1977;47:37–39.
33.
BedfordRF. Long-term radial artery cannulation: Effects on subsequent vessel function. Crit Care Med1978;6:64–67.
34.
BedfordRF. Wrist circumference predicts the risk of radial-arterial occlusion after cannulation. Anesthesiology1978;48:377–378.
35.
JohnsonRW. A complication of radial-artery cannulation. Anesthesiology1974;40:598–600.
36.
WyattR, GlavesI, CooperDJ. Proximal skin necrosis after radial-artery cannulation. Lancet1974;1:1135–1138.
37.
MayerR, MatlakME, ThompsonJA. Necrosis of the fore-arm following radial artery catheterization in a patient with Reye's syndrome. Pediatrics1980;65:141–143.
38.
KatzAM, BirnbaumM, MoylanJ, PellettJ.Gangrene of the hand and forearm: A complication of radial artery cannulation. Crit Care Med1974;2:270–272.
39.
PalmT.Evaluation of peripheral arterial pressure on the thumb following radial artery cannulation. Br J Anaesth1977;49:819–823.
40.
WaltonJR, ShapiroBA, HarrisonRA, DavisonR, ReisbergBE. Serratia bacteremia from mean arterial pressure monitors. Anesthesiology1975;43:113–114.
41.
WeinsteinRA, EmoriTG, AndersonRL, StammWE. Pressure transducers as a source of bacteremia after open heart surgery. Chest1976;69:338–344.
42.
StammWE, ColellaJJ, AndersonRL, DixonRE. Indwelling arterial catheters as a source of nosocomial bacteremia. N Engl J Med1975;292:1099–1102.
43.
DavisFM, CornereB.Bacterial contamination of radial artery catheters. NZ Med J1979;89:128–130.
44.
GardnerRM, SchwartzR, WongHC, BurkeJP. Percutaneous indwelling radial-artery catheters for monitoring cardiovascular function. N Engl J Med1974;290:1227–1231.
45.
LantiegneKC, CivettaJM. A system for maintaining invasive pressure monitoring. Heart Lung1978;7:610–621.
46.
EvansPJD, KerrJH. Arterial occlusion after cannulation. Br Med J1975;3:197–199.
47.
MarshallG, EdelsteinG, HirshmanCA. Median nerve compression following radial arterial puncture. Anesth Analg1980;59:953–954.
48.
GilliesIDS, MorganM, SykesMK, BrownAE, JonesNO. The nature and incidence of complications of peripheral arterial puncture. Anaesthesia1979;34:506–509.
49.
ColeP, LumleyJ.Arterial puncture. Br Med J1966;1:1277–1278.
50.
GurmanG, NesslerR, ShacharJ.The use of alpha-system set for arterial catheterization. Anaesthetist1980;29:494–497.
51.
PearseRG. Percutaneous catheterisation of the radial artery in newborn babies using transillumination. Arch Dis Child1978;53:549–554.
52.
WardRJ, GreenHD. Arterial puncture as a safe diagnostic aid. Surgery1965;57:672–675.
53.
DavisFM. Radial artery cannulation: Influence of catheter size and material on arterial occlusion. Anaesth Intensive Care1978;6:49–53.
54.
TodresID, RogersMC, ShannonDC, MoylanFMB, RyanJF. Percutaneous catheterization of the radial artery in the critically ill neonate. J Pediatr1975;87:273–275.
55.
SabinS, TaylorJR, KaplanAI. Clinical experience using a small-gauge needle for arterial puncture. Chest1976;69:437–439.
56.
DotyDB, MoseleyRV. Reliable sampling of arterial blood. Surg Gynecol Obstet1970;130:701–703.
57.
HarringtonDP. Disparities between direct and indirect arterial systolic blood-pressure measurements. CVP1978;6 (Aug-Sep):40–44.
58.
HallJR, PoultonTJ, DownsJB, HawkinsIFJr, CrawfordCA. In vivo arterial blood gas analysis: An evaluation. Crit Care Med1980;8:414–417.
AllenEV. Thromboangiitis obliterans: Methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases. Am J Med Sci1929;178:237–244.
75.
RichardsFL. Peripheral arterial disease, a physician's approach. Edinburgh: Livingstone, 1970:47.
76.
ShapiroBA, HarrisonRA, WaltonJR. Clinical application of blood gases. 2nd ed. Chicago: Year Book Medical Publishers, 1977:148–149.
MokrohiskyST, LevineRL, BlumhagenJD, WesenbergRL, SimmonsMA. Low positioning of umbilical-artery catheters increases associated complications in newborn infants. N Engl J Med1978;299:561–564.
81.
BookLS, HerbstJJ, StewartD.Hazards of calcium gluconate therapy in the newborn infant: Intra-arterial injection producing intestinal necrosis in rabbit ileum. J Pediatr1978;92:793–797.
82.
BookLS, HerbstJJ. Intra-arterial infusions and intestinal necrosis in the rabbit: Potential hazards of umbilical artery injections of ampicillin, glucose, and sodium bicarbonate. Pediatrics1980;65:1145–1149.
83.
BuckspanGS, FranklinJD, NovakGR, BennettBD, LynchJB, DeanRH. Intra-arterial drug injury: Studies of etiology and potential treatment. J Surg Res1978;24:294–301.
