[Hemodynamic monitoring using a long radial catheter]

Percutaneous radial artery catheterization for blood gas monitoring and continuous arterial pressure recording has become a common procedure in the management of patient undergoing cardiac surgery operations. Since radial artery pressure does not accurately reflect central aortic pressure, in the immediate post bypass period and in low cardiac output states, specially during catecholamine infusion, a long arterial line is necessary. The author has been using several techniques of central arterial cannulation from 1980 to 2002 in 6303 procedures using central radial artery, including 734 patients with Length of Stay (LOS) >96 h, and 1880 patients with Seldinger Technique, using polyurethane Arrow catheter 16 G 50 cm. The use of long radial catheter has been recently associated, for the control pulse analysis, with Picco technology successfully in 74 patients undergoing cardiac and vascular surgery operations, having no complication. The author referred on the clinical aspect connected with the use of central radial catheter with special emphasis on safety of the procedure. a) Large retrospective review on the use of long arterial catheter (6303), including prospective (50 patients) Trial of consecutive unrandomized patients. b)

Cardiac surgery end vascular department in a large over 1000 beds and 4 Hospitals Administration (the study has been limited to cardiac surgery unit).