Related Experiment Video
Updated: May 27, 2025
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Safety and Sustainability of Axillary Versus Radial Arterial Catheters in Critically Ill Children: A Retrospective
Rotem Davidovich1,2, Eytan Kaplan2,3, Gili Kadmon2,3
1Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Background:
Arterial catheters are commonly used for hemodynamic monitoring and blood sampling in critically ill children, with the radial artery being the typical site. When radial cannulation is not feasible, alternative sites like the axillary artery may be utilized. However, the safety and sustainability of axillary arterial catheters compared to radial catheters in this population remain unclear.
Aims:
This study aims to assess the safety and sustainability of axillary arterial catheters compared to radial arterial catheters in pediatric intensive care unit patients.
Methods:
We conducted a retrospective, case-control study at a university-affiliated tertiary care pediatric intensive care unit. Patients aged 18 years or younger with axillary arterial catheters from January 2007 to December 2023 were compared to patients of similar ages with radial catheters.
Results:
A computerized chart review identified 306 patients with axillary catheters, compared to 306 randomly selected patients with radial catheters. The rate of catheter site replacement was identical in both groups (40 out of 306). The median duration of axillary catheter use was 34 h longer (95% CI: 24-48; p < 0.001). Only one patient in the axillary group (0.33%) experienced a vascular complication, recovering fully after intervention. Patients with axillary catheters were characterized by a higher Pediatric Index of Mortality 3 scores, Vasoactive-Inotropic Scores, and PICU mortality rates.
Conclusions:
In this critically ill pediatric cohort, axillary arterial catheters were used longer and in a more severely ill population than radial catheters. Despite these differences, both catheter types demonstrated comparable safety and sustainability profiles.
Related Concept Videos
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:14Temperature Measurement Sites
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...