Measurement of arterial pressure after cardiopulmonary bypass with long radial artery catheters

Rulf, E. N. R.; Mitchell, Mark; Prakash, O.; Rijsterborg, Hans; Cruz, Eddy; Deryck, Yvon; Rating, W.; Schepp, Ronald M.; Siphanto, King; Woerd, A. Van Der

doi:10.1016/0888-6296(90)90441-h

Cited by 15 publications

(7 citation statements)

References 11 publications

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“…Second, it is possible to use an axillary arterial pressure line via long radial arterial catheter for central blood pressure measurement. 9,20 Although brachial arterial lines may provide a better estimate compared to radial arterial lines, the former may be ineffective in reflecting central pressure. 9,21 Finally and most importantly, intermittent non-invasive blood pressure (NIBP) monitoring can be used in addition to measurement of radial SAP.…”

Section: Discussionmentioning

confidence: 99%

Pressure difference between radial and femoral artery pressure in minimally invasive cardiac surgery using retrograde perfusion

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Pressure difference between radial and femoral artery pressure in minimally invasive cardiac surgery using retrograde perfusion

et al. 2018

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“…Despite this, TPTD has also been validated using a special catheter via the radial artery approach [ 4 ]. This catheter is 50 cm long in order to reach the subclavian artery and receive a true reflection of central aortic pressure [ 5 ]. Due to the increased diameter and length compared to a conventional radial arterial line (4 Fr and 50 cm vs. 2.7 Fr and 8 cm), the radial TPTD arterial line might induce more complications including ischemic events and long-term impairment of blood flow compromising distal perfusion, especially if the collateral circulation is damaged [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Late evaluation of upper limb arterial flow in patients after long radial (PiCCO™) catheter placement

Rovira

Aguilar

Cuñat

et al. 2015

Ann. Intensive Care

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BackgroundThe purpose of the study was to assess blood flow in the upper limb arteries after prolonged catheterization with long radial artery catheters (LRC) which reach the subclavian artery compared to catheterization with standard short radial artery catheters (SRC) and a group of upper limb flow without any catheter placement (NOCATH), with both SRC and NOCATH as control groups.MethodsProspective observational study with 20 patients admitted to ICU (40 upper limbs) with LRC and/or SRC inserted >48 h for hemodynamic monitoring. More than 45 days after catheter withdrawal, patients underwent a Doppler ultrasound study of both upper limbs. Arterial flows of arms with LRC (FlowLRC) were compared with arterial flows of arms with SRC (FlowSRC) and those without any catheter (FlowNOCATH).ResultsFlow in the ulnar, brachial, and subclavian arteries did not show any significant difference between the two types of catheters. The only significant difference was in the radial arteries, showing a lower mean flow in the arms with LRC than in the arms with SRC (2.2 vs. 8.5 cc/min; p = 0.041). Flow reduction in the radial artery (74%) in the arms with LRC compared to the SRC arms showed a tendency to increase ulnar flow as a compensatory mechanism. None of the patients with LRC included in our study had any ischemic events, in spite of observing complete flow occlusion in three radial arteries (18%) from the Doppler study.ConclusionsIn this sample, the use of PiCCO long radial catheters reaching the subclavian artery did not produce chronic significant changes in brachial or subclavian flows. However, LRC produces a significant reduction in radial flow and a tendency to increase ulnar flow. When comparing these blood flow changes with those produced by SRC use, only the radial flow reduction was significantly lower, whereas the other arterial flow changes did not significantly differ.

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“…In addition to being able to measure cardiac output, the use of a centrally placed arterial catheter may also be advantageous for more accurate blood pressure measurement. After separation from cardiopulmonary bypass, it has been demonstrated that mean radial artery pressure may underestimate central mean aortic pressure by > 10 mmHg in 60% of patients [10], or by > 20 mmHg in 15%[13]. Similar findings may be found in septic patients receiving inotropic support.…”

Section: Discussionmentioning

confidence: 80%

“…More recently, Clementi reported no complications in a report of 6303 procedures over a 22‐year period [14], whilst Rulf et al . had no significant complications in 68 patients [13]. In particular, Clementi's study included 74 patients with a 50 cm catheter for use with the PiCCO system, although the author did not report on the accuracy of the radial catheter.…”

Section: Discussionmentioning

confidence: 99%

“…However, radial artery pressure can significantly underestimate central aortic pressure under certain conditions, in particular after cardiopulmonary bypass [10] and during vasopressor therapy [11]. The use of a long radial catheter for the estimation of aortic pressure was first described in 1974 [12], and has been further validated more recently for measuring true central blood pressure [13]. In particular, the use of a long radial catheter appears to have a low complication rate [14].…”

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Measurement of cardiac output by transpulmonary arterial thermodilution using a long radial artery catheter. A comparison with intermittent pulmonary artery thermodilution

Orme¹,

Pigott

Mihm

2004

Anaesthesia

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Cardiac output can be measured accurately by transpulmonary arterial thermodilution using the PiCCO (Pulsion Medical Systems, Munich, Germany) system with a femoral artery catheter. We have investigated the accuracy of a new 50 cm 4 French gauge radial artery catheter and the ability to use the system with a shorter radial catheter. We studied 18 patients who had undergone coronary artery surgery and made three simultaneous measurements of cardiac output by arterial thermodilution and with a pulmonary artery catheter. The radial catheter was withdrawn in 5 cm increments and the measurements were repeated. We found close agreement between arterial thermodilution and pulmonary artery thermodilution with a mean (SD) bias of 0.38 (0.77) l x min(-1). Arterial thermodilution became unreliable once the catheter had been withdrawn by more than 5 cm. We conclude that cardiac output measurement with arterial thermodilution with a radial catheter is interchangeable with that derived from a pulmonary artery catheter, and that a centrally sited arterial catheter is required for accurate determination of cardiac output by transpulmonary arterial thermodilution.

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Measurement of arterial pressure after cardiopulmonary bypass with long radial artery catheters

Cited by 15 publications

References 11 publications

Pressure difference between radial and femoral artery pressure in minimally invasive cardiac surgery using retrograde perfusion

Pressure difference between radial and femoral artery pressure in minimally invasive cardiac surgery using retrograde perfusion

Late evaluation of upper limb arterial flow in patients after long radial (PiCCO™) catheter placement

Measurement of cardiac output by transpulmonary arterial thermodilution using a long radial artery catheter. A comparison with intermittent pulmonary artery thermodilution

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