Nosocomial infections associated with long-term radial artery cannulation

Leroy, Olivier; Billiau, V.; Beuscart, C.; Santré, Ch.; Chidiac, Christian; Ramage, Carmel; Mouton, Y

doi:10.1007/bf00271059

Cited by 49 publications

(23 citation statements)

References 27 publications

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“…The number of cases of AC-related bacteremia in our study was low and comparable to that in most other reported studies (5,7,10,25). The number of cases of CVC-related bacteremia (one for 308 CVCs) was similar to that in a previous study in which we found two instances of CRB among 230 CVC recipients (13).…”

Section: Discussionsupporting

confidence: 89%

Prospective study of arterial and central venous catheter colonization and of arterial- and central venous catheter–related bacteremia in intensive care units*

Traoré

Liotier

Souweine

2005

Critical Care Medicine

104

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Section: Discussionsupporting

confidence: 89%

Prospective study of arterial and central venous catheter colonization and of arterial- and central venous catheter–related bacteremia in intensive care units*

Traoré

Liotier

Souweine

2005

Critical Care Medicine

104

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“…187 It has been suggested that local injury induced by an indwelling radial artery catheter, together with radial artery constriction at the time of decannulation, can promote thrombus formation. [195][196][197][198][199][200][201][202][203][204][205][206] There is controversy as to whether radial artery cannulation is associated with a decreased incidence of infections compared with femoral artery cannulation. 180 -182,188 -191 In the review by Scheer et al, 8 the incidence of permanent hand ischemic damage was 0.09%.…”

Section: Complications Of Radial Artery Cannulationmentioning

confidence: 99%

Radial Artery Cannulation: A Comprehensive Review of Recent Anatomic and Physiologic Investigations

Brzeziński¹,

Luisetti²,

London³

2009

Anesthesia &Amp; Analgesia

295

226

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Consistent anatomic accessibility, ease of cannulation, and a low rate of complications have made the radial artery the preferred site for arterial cannulation. Radial artery catheterization is a relatively safe procedure with an incidence of permanent ischemic complications of 0.09%. Although its anatomy in the forearm and the hand is variable, adequate collateral flow in the event of radial artery thrombosis is present in most patients. Harvesting of the radial artery as a conduit for coronary artery bypass grafting, advances in plastic and reconstructive surgery of the hand, and its use as an entry site for cardiac catheterization has provided new insight into the collateral blood flow to the hand and the impact of radial arterial instrumentation. The Modified Allen's Test has been the most frequently used method to clinically assess adequacy of ulnar artery collateral flow despite the lack of evidence that it can predict ischemic complications in the setting of radial artery occlusion. Doppler ultrasound can be used to evaluate collateral hand perfusion in an effort to stratify risk of potential ischemic injury from cannulation. Limited research has demonstrated a beneficial effect of heparinized flush solutions on arterial catheter patency but only in patients with prolonged monitoring (>24 h). Conservative management may be equally as effective as surgical intervention in treating ischemic complications resulting from radial artery cannulation. Limited clinical experience with the ultrasound-guided arterial cannulation method suggests that this technique is associated with increased success of cannulation with fewer attempts. Whether use of the latter technique is associated with a decrease in complications has not yet been verified in prospective studies. Research is needed to assess the safety of using the ulnar artery as an alternative to radial artery cannulation because the proximity and attachments of the ulnar artery to the ulnar nerve may potentially expose it to a higher risk of injury.

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“…Peripheral arterial catheters (pACs) are used extensively in intensive care units (ICUs) [1][2][3][4][5][6][7], allowing continuous blood-pressure monitoring, blood gas measurements and other samplings. However, the use of pACs may lead to complications, particularly catheter-related infections (CRIs).…”

mentioning

confidence: 99%

Is routine changing of peripheral arterial catheters justified?

Blot

Estphan

Boughaba

et al. 2008

Clinical Microbiology and Infection

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Although peripheral arterial catheters (pACs) are used extensively, disagreement persists concerning the practice of scheduled replacement to prevent catheter-related infections. Despite recommendations and no proof of benefit, pAC replacement continues to be scheduled as a routine practice in many intensive care units (ICUs) worldwide. Our own experience in an oncology ICU, based on a 217-device database, confirms that the risk for pAC-related infections is stable over time, arguing against scheduled replacement. The low rate and stability of the risk of pAC-related infections supports the rationale for conservative management in accordance with expert recommendations.

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Nosocomial infections associated with long-term radial artery cannulation

Cited by 49 publications

References 27 publications

Prospective study of arterial and central venous catheter colonization and of arterial- and central venous catheter–related bacteremia in intensive care units*

Prospective study of arterial and central venous catheter colonization and of arterial- and central venous catheter–related bacteremia in intensive care units*

Radial Artery Cannulation: A Comprehensive Review of Recent Anatomic and Physiologic Investigations

Is routine changing of peripheral arterial catheters justified?

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