Arterial line cannulation in children: Is it time for guidelines?

Tosetti, Sylvain; Bertolizio, Gianluca; Withington, Davinia E.; Collard, Vincent; Ingelmo, Pablo

doi:10.1111/pan.13394

Cited by 2 publications

(5 citation statements)

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“…Pese a que no existe una pauta estandarizada para la elección y cuidado de la vía arterial utilizada, tanto la vía radial como la vía femoral son los accesos más comúnmente utilizados 3 . El tamaño arterial es directamente proporcional a la edad y peso de los pacientes, por lo que el tamaño del catéter utilizado y la oclusión que pueda causar están directamente relacionados [11][12][13] .…”

Section: Discussionunclassified

“…Los tamaños para la cateterización arterial en vía femoral utilizados suelen ser de 2.5 a 4 Fr; en nuestra serie no recogimos en nuestros datos el tamaño del catéter utilizado por falta de reporte de este en la historia clínica 13 . La cateterización radial es levemente más oclusiva con respecto a la vía femoral 3 .…”

Section: Discussionunclassified

“…Este procedimiento no está exento de riesgos, especialmente en población pediátrica; estas suelen ser menores, como hematomas y dolor. Sin embargo, se han descrito complicaciones más graves, que van desde el daño de las estructuras anatómicas adyacentes (nervios) hasta la oclusión de la arteria, lo que puede conducir a eventos isquémicos permanentes 3 .…”

Section: Introductionunclassified

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Isquemias arteriales infantiles asociadas a cateterización arterial

Mondragón-Zamora¹,

Mendieta-Azcona²,

Marin-Manzano³

et al. 2023

RMA

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La trombosis arterial asociada a catéter en población pediátrica está infraestimada y no existe un tratamiento estandarizado. Objetivo: Describir la evolución de los niños que han presentado isquemia arterial aguda en alguna extremidad asociada al uso de catéter. Métodos: Se incluyeron pacientes con clínica de isquemia arterial aguda asociada a cateterismo arterial pese al uso de vasopresores. Se recogieron y analizaron las variables demográficas, clínicas, del acceso, tratamiento y complicaciones. Resultados: Se incluyeron 25 pacientes con una edad media de 2.4 años. En 22 pacientes (88%) la isquemia se localizó en miembros inferiores. Todos los pacientes presentaron clínica de isquemia arterial. En todos los pacientes se retiró el catéter y 21 pacientes recibieron anticoagulación. La mortalidad a los 30 días fue del 40%. Los 15 supervivientes evolucionaron favorablemente. Conclusiones: La evolución de la isquemia arterial aguda en población infantil va asociada a la evolución de su patología de base. El manejo conservador es una opción aceptable.

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Section: Discussionunclassified

Section: Introductionunclassified

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Isquemias arteriales infantiles asociadas a cateterización arterial

Mondragón-Zamora¹,

Mendieta-Azcona²,

Marin-Manzano³

et al. 2023

RMA

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“…[3][4][5] Complications related to arterial cannulation in children range from minor complications, such as a localized hematoma, to major complications including acute interruption of arterial blood supply resulting in permanent ischemia and infection. 4,[6][7][8][9] The majority of complications related to arterial cannulation occur in cases of cardiac catheterization, which usually involve larger sheath and cannula sizes, compared to arterial cannulation, for perioperative monitoring purposes. 9,10 However, based on clinical observation of several complications related to femoral arterial lines placed for perioperative monitoring purposes, we performed a larger study to further examine major shortterm complications of arterial cannulation for perioperative monitoring in children.…”

Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

“…Larger, multicenter prospective studies with standardized identification and definition of complications are needed to more clearly identify risk factors and to provide better guidance for clinicians to minimize risks of arterial cannulation in children. 8…”

Section: Complications Of Arterial Lines In Childrenmentioning

confidence: 99%

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

et al. 2020

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Background Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of major short-term complications associated with arterial cannulation for perioperative monitoring in children, and (2) describe the rates of major complications by anatomical site and age category of the patient. Methods The authors examined a retrospective cohort of pediatric patients (age less than 18 yr) undergoing surgical procedures at a single academic medical center from January 1, 2006 to August 15, 2016. Institutional databases containing anesthetic care, arterial cannulation, and postoperative complications information were queried to identify vascular, neurologic, and infectious short term complications within 30 days of arterial cannulation. Results There were 5,142 arterial cannulations performed in 4,178 patients. The most common sites for arterial cannulation were the radial (N = 3,395 [66.0%]) and femoral arteries (N = 1,528 [29.7%]). There were 11 major complications: 8 vascular and 3 infections (overall incidence, 0.2%; rate, 2 per 1,000 lines; 95% CI, 1 to 4) and all of these complications were associated with femoral arterial lines in children younger than 5 yr old (0.7%; rate, 7 per 1,000 lines; 95% CI, 4 to 13). The majority of femoral lines were placed for cardiac procedures (91%). Infants and neonates had the greatest complication rates (16 and 11 per 1,000 lines, respectively; 95% CI, 7 to 34 and 3 to 39, respectively). Conclusions The overall major complication rate of arterial cannulation for monitoring purposes in children is low (0.2%). All complications occurred in femoral arterial lines in children younger than 5 yr of age, with the greatest complication rates in infants and neonates. There were no complications in distal arterial cannulation sites, including more than 3,000 radial cannulations. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Arterial line cannulation in children: Is it time for guidelines?

Cited by 2 publications

References 5 publications

Isquemias arteriales infantiles asociadas a cateterización arterial

Isquemias arteriales infantiles asociadas a cateterización arterial

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

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