Document Detail


Analysis of major complications associated with arterial catheterisation.
MedLine Citation:
PMID:  20194221     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Arterial catheterisation is used for continuous haemodynamic monitoring in patients undergoing surgery and in critical care units. Although it is considered a safe procedure, a major complication such as arterial occlusion and limb gangrene can occur.
OBJECTIVE: To determine the incidence, outcome and potential to avoid complications associated with arterial catheterisation.
METHODS: The number of arterial catheterisation was determined using an anaesthesiology and critical care medicine billing database over a period of 4 years (1 January 2003 to 31 December 2006). Possible major complications were identified from two hospital databases; all identified charts were screened and then reviewed by an expert panel that determined causation. A major complication was defined as requiring operative intervention and/or resulting in permanent harm.
RESULTS: 15 (0.084%) major complications were identified among 17 840 instances of arterial catheterisation insertions. Of 15 arterial catheterisations, nine were performed in the operating room and six in the intensive care unit. Nine patients suffered ischaemic injury, which progressed to gangrene in three patients. Three patients developed haematoma that required surgical evacuation; two of these required vascular repair. One patient had compartment syndrome requiring fasciotomy and two patients had sheared catheter fragments that needed to be removed. All 15 patients had multiple comorbidities, and those in the operating room had an American Society of Anesthesiologists score of >or=3. Seven (46.6%) had arterial catheterisation done under emergent circumstances. Six (40%) died during hospitalisation because of complications unrelated to arterial catheterisation.
CONCLUSION: Arterial catheterisation had a very low rate of major complications. They seem associated with high severity of illness and emergency surgery.
Authors:
A A Salmon; S Galhotra; V Rao; Michael A DeVita; J Darby; I Hilmi; R L Simmons
Publication Detail:
Type:  Journal Article     Date:  2010-03-01
Journal Detail:
Title:  Quality & safety in health care     Volume:  19     ISSN:  1475-3901     ISO Abbreviation:  Qual Saf Health Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136980     Medline TA:  Qual Saf Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  208-12     Citation Subset:  H    
Affiliation:
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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