Radial Arterial Lines Have a Higher Failure Rate than Femoral
Matthew R Greer1, Scott Carney1, Rick A McPheeters1
1Kern Medical, Bakersfield, Department of Emergency Medicine, Bakersfield, California.
The Western Journal of Emergency Medicine
|March 22, 2018
Summary
Femoral arterial lines demonstrate significantly lower failure rates compared to radial arterial lines in critically ill patients. Preferential use of femoral arterial lines could prevent one line failure for every four lines placed.
Area of Science:
- Critical Care Medicine
- Vascular Access
- Clinical Outcomes Research
Background:
- Arterial lines are crucial for hemodynamic monitoring in critically ill patients.
- Common insertion sites include femoral and radial arteries, but evidence guiding site selection is limited.
Purpose of the Study:
- To compare the failure rates of femoral versus radial arterial lines.
- To identify factors influencing arterial line failure.
Main Methods:
- Ambispective, observational cohort study.
- Evaluated 272 arterial lines (femoral and radial) placed in adult patients between 2012 and 2016.
- Assessed line failure causes: inaccuracy, blockage, site issue, or accidental removal.
Main Results:
- Overall failure rate was 21.32% (58/272 lines).
- Femoral lines had significantly lower failure rates (5.36% retrospective, 5.41% prospective) compared to radial lines (30.71% retrospective, 25.64% prospective).
- Absolute risk reduction for femoral lines was 20.2%; failures occurred sooner in radial sites.
Conclusions:
- Femoral arterial lines exhibit substantially lower failure rates than radial arterial lines.
- Preferential placement of femoral arterial lines may reduce line failures by approximately 25%.
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