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Axillary arterial monitoring of pediatric patients
1Department of Anesthesia/Critical Care Medicine and Pediatrics, Children's Hospital, Pittsburgh, Pennsylvania.
Insights
Axillary artery catheterization for hemodynamic monitoring is safe in pediatric patients. This study found no major complications or negative effects on blood pressure in children, supporting its use in pediatric critical care.
Area of Science:
- Pediatric Critical Care Medicine
- Vascular Access
- Hemodynamic Monitoring
Background:
- Axillary artery catheterization is established for hemodynamic monitoring in adults.
- Limited data exists on its safety and complications in pediatric populations.
Purpose of the Study:
- To evaluate the safety and complications of axillary artery catheterization for pressure monitoring in pediatric patients.
- To assess the impact on neurologic and vascular function compared to the contralateral arm.
Main Methods:
- Retrospective evaluation of 16 pediatric patients with axillary lines for pressure monitoring.
- Neurologic and vascular function assessed by comparing the catheterized arm to the non-catheterized arm.
Main Results:
- No major complications were observed during axillary artery monitoring.
- Post-decannulation, no significant difference in systolic blood pressure was found between the two arms.
Conclusions:
- Axillary artery catheterization is a safe and effective method for intra-arterial monitoring in pediatric patients.
- It does not adversely affect concurrent or future blood pressure monitoring in this population when performed with skilled nursing care.
Abstract:
Use of the axillary artery for hemodynamic monitoring has gained acceptance in critically ill adults. However, there is little information concerning the safety and complications of such catheters in the pediatric population. Sixteen pediatric patients who had axillary lines placed for pressure monitoring were evaluated for neurologic and vascular function, by comparing the arm with the axillary line with the contralateral arm. There were no major complications during axillary artery monitoring. After decannulation, systolic blood pressure did not differ between arms. In a pediatric critical care environment with skilled ongoing nursing care, the axillary artery can be used as a site for intraarterial monitoring in pediatric patients without a detrimental effect on concurrent or future blood pressure monitoring.
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