Radial arterial catheters in children and neonates: a prospective study

Over a 3-yr period (1982 to 1984), 533 arterial catheters were inserted in 476 patients admitted to the pediatric ICU or the operating room. Radial arterial catheterization with small-bore, 0.8-mm, 22-ga Teflon cannulas was the most common method (376 of 533 cannulations), and 296 of these catheters were inserted in patients less than 1 yr of age. All catheters were flushed intermittently with heparin (12.5 U/ml) in isotonic saline. The mean catheter duration was 2.6 days, and only minor complications were noted. The main reason for catheter removal was malfunction of the arterial line. There was no difference in duration or complication rate between catheters inserted percutaneously or by cutdown. Over a 6-month period (1985 to 1986), 42 0.8-mm, 22-ga radial arterial catheters were inserted in 39 patients less than 1 yr of age; all catheters were maintained by a continuous flushing system using heparin (5 U/ml) in isotonic saline. The mean duration was 6.3 days. No complications were noted, and the proportion of catheter malfunction decreased. This study confirms the safety of radial arterial catheterization in children and neonates. The continuous flushing system considerably improved catheter patency compared to a method using intermittent flushing.