Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass

Cho, Hwa Jin; Lee, Sang Hoon; Jeong, In Seok; Yoon, Nam Sik; Sook, Jae; Ahn, Byoung Hee

doi:10.1016/j.jped.2017.03.011

Cited by 11 publications

(11 citation statements)

References 13 publications

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“…2,3 In addition, there are reported differences in blood pressure measurements in neonates and infants undergoing cardiac procedures. 19 Consequently, alternative and proximal sites of arterial cannulation in neonates and infants may be sought, including femoral arterial cannulation, which is what we observed in our cohort. 5,6 Femoral arterial cannulation was the preferred site of arterial cannulation in the neonate and infant age groups.…”

Section: Complications Of Arterial Lines In Childrensupporting

confidence: 51%

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

et al. 2020

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Background Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of major short-term complications associated with arterial cannulation for perioperative monitoring in children, and (2) describe the rates of major complications by anatomical site and age category of the patient. Methods The authors examined a retrospective cohort of pediatric patients (age less than 18 yr) undergoing surgical procedures at a single academic medical center from January 1, 2006 to August 15, 2016. Institutional databases containing anesthetic care, arterial cannulation, and postoperative complications information were queried to identify vascular, neurologic, and infectious short term complications within 30 days of arterial cannulation. Results There were 5,142 arterial cannulations performed in 4,178 patients. The most common sites for arterial cannulation were the radial (N = 3,395 [66.0%]) and femoral arteries (N = 1,528 [29.7%]). There were 11 major complications: 8 vascular and 3 infections (overall incidence, 0.2%; rate, 2 per 1,000 lines; 95% CI, 1 to 4) and all of these complications were associated with femoral arterial lines in children younger than 5 yr old (0.7%; rate, 7 per 1,000 lines; 95% CI, 4 to 13). The majority of femoral lines were placed for cardiac procedures (91%). Infants and neonates had the greatest complication rates (16 and 11 per 1,000 lines, respectively; 95% CI, 7 to 34 and 3 to 39, respectively). Conclusions The overall major complication rate of arterial cannulation for monitoring purposes in children is low (0.2%). All complications occurred in femoral arterial lines in children younger than 5 yr of age, with the greatest complication rates in infants and neonates. There were no complications in distal arterial cannulation sites, including more than 3,000 radial cannulations. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Section: Complications Of Arterial Lines In Childrensupporting

confidence: 51%

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

et al. 2020

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“…According to studies, increasing CPB time can increase the complications. Confirming this issue, Cho (2017) with multivariate analysis, showed that longer CPB time (>60 min, odds ratio: 7.47) was a risk factor for lower radial pressure ( 32 ) and in the study of Radmehr (2010), in the group that had increase in preoperative creatinine, the CPB time was longer ( 33 ). The present study was a propos of the first objective of the research, which was “to determine the relationship between duration of the CPB pump (min) and incidence of AF after open heart surgery”, the obtained results indicated no significant relationship between duration of the CPB pump and incidence of AF.…”

Section: Discussionmentioning

confidence: 96%

Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): a cohort study

Rajabi¹,

Safarpoor²,

Borzou³

et al. 2018

Electron Physician

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BackgroundOpen heart surgery is one of the most common and valuable treatment methods for cardiovascular diseases, a common side effect of which is atrial fibrillation that occurs due to various reasons.ObjectiveTo determine the relationship between incidence of atrial fibrillation (AF) and duration of cardiopulmonary bypass (CPB) in patients after open heart surgery.MethodsThe present retrospective cohort study was conducted on 330 patients in Farshchian Heart Center through census. The required data were collected from medical records of the patients undergoing coronary bypass surgery using data collection between April 2015 and March 2015. Then, data analysis was performed using SPSS software (ver.16) at error level of p<0.05. The tests used in this study included independent-samples t-test, Mann-Whitney, and chi-squared tests.ResultsBased on the results, mean age of the patients was 61.76±9.2, the majority of the patients (70.1%) were male. The association between Incidence of Atrial Fibrillation and cardiopulmonary pump time (minute) was not meaningful. Incidence of atrial fibrillation had statistically significant relationship with variables of mean age, BMI, PAC, PVC, creatinine and duration of hospitalization (p<0.05); on the other hand, variables of gender, cross clamp time (minute), intubation time (hour), and clinical history had no effect on atrial fibrillation incidence rate (p>0.05).ConclusionSince the pathogenesis of AF after cardiac surgery is believed to be multifactorial, including clinical variables and technical intraoperative factors, the relation between incidence of AF with mean age, BMI, PAC, PVC, creatinine and duration of hospitalization was significant. But AF was not related to cardiopulmonary pump time (minute). It is necessary to conduct further research on factors affecting incidence of atrial fibrillation.

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“…The femoral artery is the largest accessible artery for arterial catheterization and continues from the external iliac and common iliac arteries. Because femoral arterial pressure represents the central arterial pressure, femoral arterial catheterization is useful in cardiopulmonary bypass [ 21 , 22 ] or liver transplantation [ 23 ], when peripheral arterial pressure monitoring does not reflect central blood pressure. The average diameter of the common-, superficial-, and deep-femoral artery in adults is 6.6 ± 1.2 mm, 5.2 ± 1.2 mm, 4.9 ± 0.9 mm [ 24 ], respectively.…”

Section: Anatomymentioning

confidence: 99%

“…Furthermore, complications vary depending on the catheterization site. Recently, the overall major complication rate within 30 days was 0.034–0.2% in adults [ 4 ] and children [ 5 ], but the complication rate related to the femoral artery was 0.7–25% in children [ 5 , 22 ]. Site-specific complications are related to the anatomical characteristics of these arteries.…”

Section: Complications and Preventionmentioning

confidence: 99%

Ultrasound-guided arterial catheterization

Cho¹,

Jang²,

et al. 2021

Anesth Pain Med

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Ultrasonography facilitates arterial catheterization compared to traditional palpation techniques, especially in small arteries. For successful catheterization without complications, practitioners should be familiar with the anatomic characteristics of the artery and ultrasound-guided techniques. There are two approaches for ultrasound-guided arterial catheterization: the short-axis view out-of-plane approach and the long-axis view in-plane approach. There are several modified techniques and tips to facilitate ultrasound-guided arterial catheterization. This review deals with the anatomy relevant to arterial catheterization, several methods to improve success rates, and decrease complications associated with arterial catheterization.

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Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass

Abstract: The authors suggest that femoral arterial pressure monitoring can be safely performed, even in neonates, and provides more accurate BP values during CPB-on periods, and immediately after weaning from CPB, especially when CPB time was greater than 60min.

Cited by 11 publications

References 13 publications

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): a cohort study

Ultrasound-guided arterial catheterization

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