Complications of femoral artery catheterization in pediatric burn patients

A retrospective analysis of all pediatric patients admitted for acute burn treatment during a 7-year period was conducted to examine patients who underwent femoral artery catheterization and discuss the associated complications and treatment options. The total number of femoral artery catheterizations performed, nature of vascular complications, treatment rendered, and patient outcome were reviewed. Of the 1800 acute burn pediatric patients treated during our study period (1996-2002), 234 patients underwent a total of 745 femoral artery catheterizations. There was a 1.9% incidence of significant complications as a result of catheterization, including problems during catheter insertion, diminished distal arterial pulses following catheter placement and catheter malfunction. Eight patients (3.4%) developed occlusion or spasm of the femoral artery evidenced by loss of distal pulses. Of these, three required thrombectomy and the other five were treated nonsurgically with immediate catheter removal and systemic heparinization. Both groups showed similar overall outcome with return of distal pulses and absence of distal limb or tissue loss. Our findings indicate that femoral artery catheterization in pediatric burn patients is associated with a low occurrence of vascular complications. The majority of patients with acute distal limb ischemic symptoms can be managed nonoperatively with immediate removal of the catheter and systemic heparinization.