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[Complications of arterial catheterization in children]
N d Souza1, A C Carvalho, W B Carvalho
1Unidade de cuidados intensivos pediátricos, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP.
Insights
Radial artery catheterization complications in pediatric cardiac surgery patients were analyzed. The cutdown technique led to more infections, ischemia, and hemorrhage compared to the percutaneous method, with timing also being a significant factor.
Area of Science:
- Pediatric Intensive Care
- Cardiovascular Surgery
- Vascular Access
Context:
- Radial artery catheterization is increasingly vital for monitoring in pediatric intensive care units, especially post-cardiac surgery.
- Limited literature exists on the complications associated with this procedure in pediatric populations.
Purpose:
- To investigate the complications of radial artery catheterization in children following cardiac surgery.
- To compare complication rates between percutaneous and cutdown catheterization techniques.
- To assess the influence of catheter dwell time on complication incidence.
Summary:
- A study of 120 pediatric cardiac surgery patients (1 month to 2 years) examined complications from percutaneous (n=67) and cutdown (n=53) radial artery catheterization.
- The cutdown technique was associated with significantly higher rates of local infection, hemorrhage, and ischemia.
- Catheter occlusion and accidental displacement rates were similar between techniques. Infection risk increased after 72 hours, while hemorrhage and ischemia were more prevalent within the first 72 hours.
Impact:
- Findings highlight that the choice of catheterization technique and duration of catheter use are critical factors influencing complication rates.
- This analysis provides crucial data for optimizing radial artery catheterization practices in pediatric cardiac surgery to minimize adverse events.
Unlabelled:
The radial artery catheterization with the purpose of children's monitoring has been more and more used in Pediatric Intensive Care Units, and many times, is use is indispensable, like in cardiac surgery post-operative cases. However, there are only a few articles on the subject among us.
Purpose:
To analyse the complications of radial artery catheterization in the post-operative of cardiac surgery in children.
Methods:
We studied the complications of this procedure in 120 children in cardiac surgery post-operative range from 1 month to 2 years. The children were catheterized by percutaneous technique (n = 67) and by cutdown technique (n = 53). The following complications were analysed in relation to the placement time of the catheter and the used technique: local infection, hemorrhagic complication, ischemia, catheter occlusion and accidental catheter displacement.
Results:
Infection, ischemia and hemorrhage were more frequent and statistically significant in patients submitted to cutdown technique, while the catheter occlusion and accidental displacement were similar in both groups. The placement time of the catheter was an important variable in our study. All of the other infection cases occurred after 72 hours of the catheterization and the frequency of hemorrhage and ischemia was higher in the first 72 hours.
Conclusion:
The main complications of this proceeding are related to the technic utilized, time of utilization of the catheter and to the characteristics of the patients.