Prospective comparative study on the hemodynamic and functional consequences of arterial monitoring catheters in intensive care patients on the short and long term

• Published in: Journal of critical care 2006-06, Vol.21 (2), p.193-196
• Main Authors: Hoencamp, Rigo, Ulrich, Chris, Verschuren, Sabine A.J., van Baalen, Jari M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arteries; Blood Pressure; Catheterization; Catheters; Catheters, Indwelling - adverse effects; Critical Care; Female; Hemodynamics; Hospitalization; Hospitals; Humans; Intensive care; Intensive Care Units; Intubation; Long term; Male; Middle Aged; Monitoring, Physiologic - adverse effects; Multivariate analysis; Prospective Studies; Reference Values; Treatment Outcome; Ulnar Artery - physiopathology; Ultrasonics; Ultrasonography, Doppler; Veins & arteries
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2005.12.011

In intensive care wards, arterial catheters are a relevant instrument to monitor vital functions. However, the effect of arterial catheterization on hemodynamic function in elective patients in the short and long term is unknown. The objective of this study was to examine the possible damaging effects of arterial monitoring catheters on arterial functioning in intensive care patients after elective surgery. Twenty-three patients with an arterial catheter were examined; the nonaffected arm was used as control. The use of the a. radialis/a. ulnaris ratio for the assessment of artery functioning was validated with 20 healthy individuals and the nonaffected control arm of the examined patients. Arterial function was measured with a Doppler monitoring device and a subjective assessment distress list. All patients were assessed before insertion and 1 day, 5 days, and 30 days after removal. Data were analyzed by means of multivariate analysis of variance and t test. A significant decrease in the a. radialis/a. ulnaris ratio was found 1 day and 5 days after removal ( t1 P = .04, t5 P = .003, and multivariate analysis of variance P = .033), against no significant change after 30 days. Subjective assessment showed no relevant clinical negative impact. There is significant change in the hemodynamic function of the artery 1 day and 5 days after removal, but this significant change disappears after 30 days. An arterial monitoring catheter causes a functional arterial change in the affected arm in the short term and no significant difference in the long term. Therefore, arterial catheterization is a safe procedure after short-term cannulation. Second, the systolic blood pressure ratio of the a. radialis/a. ulnaris is a valuable tool in the assessment of the hemodynamic function of the a. radialis after radial cannulation.