Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study

The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.

To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.

Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients' clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including chi-square and Fisher's exact test. A significance level of up to 10% (p-value < 0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).

Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (p-value 0.069), need for sedation (p-value 0.011) and insertion site (p-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (p-value 0.079) and the puncture method (p-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (p-value 0.001), the use of vasoactive amines (p-value 0.032) and the insertion site (p-value 0.012) were associated with system obstruction.

The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.