Radial artery cannulation: A comparison of 15.2- and 4.45-cm catheters

Dahl, M.; Smead, William L.; McSweeney, Thomas D.

doi:10.1007/bf01616775

Cited by 19 publications

(12 citation statements)

References 21 publications

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“…Catheterization of the radial artery is common in critical ill neonates and children and is rarely followed by complications (8)(9)(10)(11)(12). Alternative approaches such as the umbilical or temporal artery are associated with serious complications (14)(15)(16)(17)(18) and are therefore not recommended.…”

Section: Discussionmentioning

confidence: 99%

Catheterization of the radial or brachial artery in neonates and infants

Schindler¹,

Kowald²,

Suess³

et al. 2005

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Catheterization of the radial or brachial artery in neonates and infants

Schindler¹,

Kowald²,

Suess³

et al. 2005

Pediatric Anesthesia

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“…14,16,17,212 Other factors reported to be associated with radial artery injury are more controversial such as the number of puncture attempts, 14,16 artery size, 16,85,105,213,215 the composition of the catheter (teflon versus polypropylene), 14,16,148,178,180,213,215,216 catheter diameter, 16,85,105,213,215 the duration of cannulation, 14,16,85,148,218,219 and gender. 222 A plethora of patient-specific (e.g., atherosclerosis), cannulation-related (e.g., thrombosis, vasospasm, emboli), and hospital course-related (e.g., hypotension, vasopressors) risk factors emphasizes the multifactorial nature of ischemic complications of indwelling radial artery cannulation making precannulation risk assessment challenging (Table 6). 14 The use of large sheaths (5F or 6F) for cannulation, as used in transradial coronary interventions, has been associated with vessel narrowing, occlusion, and subsequent failure to cannulate the radial artery.…”

Section: Risk Factors For Ischemic Hand Injury With Radial Artery Canmentioning

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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“…Although this conviction has been supported in the literature, several studies have challenged the assertion (12)(13)(14)(15)(16).…”

Section: Radial Arterial Catheterizationmentioning

confidence: 90%

“…The Allen's test and its modifications have been common screening tests advocated before radial artery catheterization or harvest (7,8,14). In the performance of the modified Allen's test, the radial artery is occluded with manual compression and blood flow is measured by Doppler in the radial artery distal to the compressed site.…”

Section: Allen's Testmentioning

confidence: 99%