Introduction
Arterial cannulation is a very useful tool in the management of patients in mechanical ventilation or hemodynamic instability. However, local complications are always a concern.
Objective
To describe complications of different arterial cannulation sites, correlating them with line obstruction, local and distal ischemia, infection and thrombosis.
Materials and methods
A prospective, observational study of the arterial cannulations performed in a clinical and surgical intensive care unit from October 2001 to November 2002. Daily evaluations for catheter obstruction (dumping of waves, difficulty in draining blood) or local and distal ischemia (livedo reticularis, pale or cyanotic extremity) were carried out. Arterial Doppler scans were obtained 24 hours after catheter removal, searching for partial or total obstructive thrombosis.
Results
Five hundred and sixty-five arterial cannulations were analyzed (Table 1).
Table 1.
| Radial | Axillary | D. pedis | Femoral | |
|---|---|---|---|---|
| n (%) | 272 | 162 | 89 | 42 |
| Obstruction | 15 (5.51%) | 4 (2.46%) | 6 (6.74%) | 1 (2.38%) |
| Ischemia | 45 (16.54%) | 0 | 7 (7.86%) | 0 |
| Pseudo-aneurisma | 0 | 1 | ||
| Thrombosis | 74 (27.2%) | 0 | 16 (17.97%) | 0 |
| Dumping wave | 19 (6.98%) | 10 (6.17%) | 14 (15.73%) | 2 (4.76%) |
| Total | 153 (56.25%) | 14 (8.64%) | 43 (48.31%) | 4 (9.52%) |
Chi square = 20.26, degrees of freedom = 5, P = 0.00111922.
Conclusion
Despite the lower utilization of the axillary artery, the number of complications favored this site for monitoring over the mostly used radial artery.