Axillary Arterial Catheterization

Bryan-Brown, Christopher W.; Lumb, P. D.; Kathirithamby, K. S.; Shapiro, Brian P.; Azer, Samy A.

doi:10.1097/00000542-197909001-00157

Cited by 7 publications

(7 citation statements)

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“…Radial catheters may produce an attenuated waveform with an exaggerated pulse pressure in states of hypovolemia and vasoconstriction. 120 Urzua et al 121 prospectively studied the effects of thermoregulatory vasoconstriction and concluded that the combination of more forceful cardiac ejection, stiffer arteries, and locally increased arteriolar resistance produced marked radial waveform distortion, artificially increasing peak systolic pressure. Finally, Dorman et al 36 studied the adequacy of radial pressure monitoring by using a prospective observational study during high-dose vasopressor administration and concluded that radial pressure underestimated central pressure and resulted in excessive vassopressor administration.…”

Section: Complicationsmentioning

confidence: 99%

The PiCCO Monitor

Oren-Grinberg¹

2010

International Anesthesiology Clinics

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Section: Complicationsmentioning

confidence: 99%

The PiCCO Monitor

Oren-Grinberg¹

2010

International Anesthesiology Clinics

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“…Both sites are relatively safe sites for insertion [54,60,61]. Other available sites include the brachial, dorsalis pedis, and axillary arteries [61,62]. Site-specific problems with arterial catheters refer to whether pressures measured directly at one site can be compared with pressures measured at another site.…”

Section: Photoplethysmographymentioning

confidence: 99%

Routine Monitoring of Critically I11 Patients

Curley

Smyrnios

1990

J Intensive Care Med

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The explosion in computer use and technology during the past several decades has dramatically changed criti cal care. All vital signs can now be monitored accu rately, noninvasively, and continuously. We examined the predominantly noninvasive methods of monitor ing temperature, arterial blood pressure, heart rate and rhythm, respiratory mechanics, and gas exchange that can be used continuously on almost every patient in the intensive care unit. We conclude that temperature should be measured either intermittently with a rectal thermometer or continuously with a rectal, bladder, or great vessel thermocouple or thermistor probe. Arterial pressure should be measured either intermittently with a sphygmomanometer and cuff or continuously with an indwelling arterial catheter, except in specific situa tions when automated indirect monitoring may be use ful. Electrocardiographic rhythm monitoring has been clearly shown to improve prognosis in patients after acute myocardial infarction and should be universal in all intensive care units. Ischemia monitoring may prove beneficial, but its role has not been clearly defined. Re spiratory inductance plethysmography is effective in measuring respiratory rate, tidal volume, and breathing pattern. Pulse oximetry is useful in detecting occult hy poxemia. It should be continuous on most patients. Transcutaneous oxygen and carbon dioxide measure ment has a limited role in monitoring gas exchange and perfusion. Capnography also has a limited role in the intensive care unit but is more helpful in the operating room.

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“…he axillary artery (AA) is frequently used in the ICU for hemodynamic monitoring. The technique of AA cannulation has been described in the literature since the 1970s, [1][2][3][4] but few recent clinical trials have been conducted.…”

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confidence: 99%

“…5 Placement of AA catheters is traditionally performed using anatomical landmarks and palpation technique. 2,3 The close proximity of the axillary artery, vein, and nerves ( Figure 1) makes injury more likely in the setting of multiple needle punctures and needle repositionings as might be expected with a nonvisual or "blind" method of vessel location. Complications of this technique include bleeding, hematoma formation, pseudoaneurysm formation (secondary to multiple puncture attempts and needle repositioning), laceration of the Utility of Ultrasound Versus Landmark-Guided Axillary Artery Cannulation for Hemodynamic Monitoring in the Intensive Care Unit " The use of ultrasound (US) guidance has been shown to increase the success rate and decrease the duration and complications associated with central venous catheter placement."…”

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Utility of Ultrasound Versus Landmark-Guided Axillary Artery Cannulation for Hemodynamic Monitoring in the Intensive Care Unit

et al. 2011

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Objectives. To assess the utility of ultrasound-guided axillary artery catheterization compared with anatomical landmark technique catheterization in the intensive care unit. Design. Randomized controlled trial. Setting. University hospital surgical and neurosurgical intensive care unit. Patients. A total of 33 critically ill patients undergoing arterial line placement. Interventions. Axillary arterial line placement under ultrasound guidance or by using anatomical landmarks. Measurements and main results. Procedure duration, number of attempts (skin punctures), needle repositionings, and aborted procedures were compared. A total of 33 patients were randomly assigned to either the ultrasound group (n = 18) or the anatomical landmark group (n = 15). Aborted procedures were significantly greater in the landmark group (n = 4) than in the ultrasound group (n = 0); P = .019. Procedure duration (mean ± SD) in the ultrasound group was 7.01 ± 4.40 minutes compared with 9.29 ± 10.00 minutes in the landmark group; P = .360. A significant reduction in overall procedure duration for fellow operators (5.83 ± 3.64 minutes) versus resident operators (11.46 ± 9.41 minutes) was noted; P = .012. The number of attempts in the landmark group was 3.07 ± 2.96 compared with 2.44 ± 1.72 in the ultrasound group; P = .46. The number of needle repositionings was 4.06 ± 2.86 times per procedure in the ultrasound group, compared with 10.00 ± 13.45 in the landmark group; P = .077. Conclusion. Ultrasound-guided axillary arterial catheter placement increases the success rate of line placement with no significant decrease in the duration of the procedure and the number of needle punctures or repositionings.

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Axillary Arterial Catheterization

Cited by 7 publications

References 0 publications

The PiCCO Monitor

The PiCCO Monitor

Routine Monitoring of Critically I11 Patients

Utility of Ultrasound Versus Landmark-Guided Axillary Artery Cannulation for Hemodynamic Monitoring in the Intensive Care Unit

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