ABSTRACT
Arterial cannulation can be used to monitor blood pressure in real time and facilitate frequent arterial blood gas analysis.It is one of the commonly used clinical techniques in anesthesia,emergency,and intensive care units.Studies have demonstrated that ultrasound guidance can increase the success rate of arterial cannulation and reduce the incidence of related complications.In recent years,ultrasound guidance technology has developed rapidly and is increasingly used in clinical practice.This article reviews the latest advances in the application of ultrasound guidance in radial artery cannulation.
Subject(s)
Blood Pressure , Catheterization, Peripheral/methods , Radial Artery/diagnostic imaging , Ultrasonography , Ultrasonography, Interventional/methodsABSTRACT
To identify the possible factors that may influence the success and the complications of ultrasound-guided out-of-plane radial arterial cannulation. Multivariate Logistic regression analysis was used to analyze the clinical data of 131 patients undergoing elective surgery and ultrasound-guided out-of-plane radial artery cannulation,dynamic needle tip positioning(DNTP) technique or angular distance(AD) technique and to find out the factors associated with the one-attempt success rate,overall success rate,posterior arterial wall perforation,and local hematoma. The depth of the anterior arterial wall≥3 mm was the factor associated with posterior arterial wall perforation(=0.314,95%:0.143-0.691,=0.004) and local hematoma(=0.250,95%:0.107-0.585,=0.001).The use of DNTP method was significantly associated with posterior arterial wall perforation(=0.303,95%:0.138-0.667,=0.003). During ultrasound-guided out-of-plane radial cannulation,puncture at the arterial anterior wall sites with a depth of≥3 mm can reduce the incidence of posterior arterial wall perforation and local hematoma.Compared with AD,DNTP can lower the incidence of posterior arterial wall perforation.
ABSTRACT
11 Extremely low birth weight neonates who developed skin discoloration after peripheral arterial catheterization were given intra-arterial papaverine before the removal of arterial line. The skin color turned normal in all these neonates and none developed residual damage. In 3 neonates who could not receive papaverine, one developed gangrene of fingers.
ABSTRACT
Background: Pseudoaneurysm formation is a rare complication of arterial puncture. Case characteristics: 3-week-old male developed an enlarging mass over the anterior aspect of left wrist following radial arterial puncture. Observation: Doppler ultrasonography revealed mass to be left radial arterial pseudoaneurysm. Subsequent presentation of ecchymoses and investigations confirmed factor VIII deficiency (Hemophilia A). Outcome: Pseudoaneurysm removed with primary end to end anastomosis. Patient is presently on regular factor VIII replacement therapy. Message: Hemophilia A can present as pseudoaneurysm in neonatal period.
ABSTRACT
Continuous measurement of arterial pressure is frequently required in the perioperative management of critically ill patients and major surgeries. The complications following arterial cannulation include hematoma, thrombosis, ischemia, infection, aneurysm formation at the site of catheter insertion, and so on. The authors report a case of the sheared catheter during the arterial cannulation and the subsequent surgical removal of its remnant.
Subject(s)
Humans , Aneurysm , Arterial Pressure , Catheterization , Catheters , Critical Illness , Hematoma , Ischemia , Thrombosis , WristABSTRACT
Arterial canuulation is generally used to monitor blood pressure and sample blood for gas analysis. Radial and dorsalis pedis arteries are commonly used for arterial cannulation. It is a simple, safe, and uncomplicated procedure, but some complications have been reported, including bleeding, hematoma, infection, pseudoaneurysm, and thromboembolism. Although thromboembolism is not common, it could be serious because it can lead to digital ischemia and necrosis. We present a case of foot necrosis following dorsalis pedis artery cannulation in a 65-year-old patient who underwent small bowel resection.
Subject(s)
Aged , Humans , Aneurysm, False , Arteries , Blood Pressure , Catheterization , Foot , Hematoma , Hemorrhage , Ischemia , Necrosis , Organothiophosphorus Compounds , ThromboembolismABSTRACT
Anesthegiologists commonly use arterial cannulation for both close blood pressure monitoring and repeated blood sampling for gas analysis. Radial artery cannulation is generally thought of as a safe and uncomplicated procedure, however, some possible complications have been reported. These include bleeding, hematoma, infection, pseudoaneurysm and thromboembolism, which do not usually result in any serious clinical problems. Although it is not common, thromboembolism could be serious because it can lead to digital ischemia and necrosis. We report here a case of finger necrosis following radial artery cannulation in a patient who underwent radical hysterectomy under general anesthesia.
Subject(s)
Humans , Aneurysm, False , Arteries , Blood Pressure Monitors , Catheterization , Fingers , Hematoma , Hemorrhage , Hysterectomy , Ischemia , Necrosis , Radial Artery , ThromboembolismABSTRACT
The arterial cannulation has been performed for continuous blood pressure monitoring and blood gas analysis in operating room. The radial artery, ulnar artery, dorsalis pedis artery and others have been used for the site of cannulation. Although arterial cannulation offers many advantages, complications can developed. The complications of arterial cannulation are pain on puncture site, hematoma, infection, and so on. However pseudoaneurysm is a rare complication. We experienced a case of pseudoaneurysm at the radial artery following catheter indwelling for 7 days in a 54-year-old male patient undergoing cerebral aneurysm clipping which was found at 84 days after operation.
Subject(s)
Humans , Male , Middle Aged , Aneurysm, False , Arteries , Blood Gas Analysis , Blood Pressure Monitors , Catheterization , Catheters , Hematoma , Intracranial Aneurysm , Operating Rooms , Punctures , Radial Artery , Ulnar ArteryABSTRACT
Radial artery cannulation is a well established clinical technique for continuous monitoring of arterial blood pressure and serial sampling of arterial blood in critically ill patients. This method is regarded generally as safe, but complications are reported uncommonly. We report a case of false aneurysm of the radial artery following repeated puncture and catheter indweling for 8 days, and discuss briefly about the complication of arterial cannulation. It should be remembered that in arterial cannulation, we must use aseptic techniques, and the catheter must not be indwelt at one point for a long time.