Document Detail

Arterial Lines in the ICU: A Call for Rigorous Controlled Trials.
MedLine Citation:
PMID:  25367469     Owner:  NLM     Status:  In-Data-Review    
The appropriate justification for using a diagnostic or therapeutic intervention is that it provides benefit to patients, society, or both. For decades, indwelling arterial catheters have been used very commonly in patients in the ICU, despite a complete absence of data addressing whether they confer any such benefits. Both of the main uses of arterial catheters, BP monitoring and blood sampling for laboratory testing, can be done without these invasive devices. Prominent among complications of arterial catheters are bloodstream infections and arterial thrombosis. To my knowledge, only a single observational study has assessed a patient-centered outcome related to arterial catheter use, and it found no evidence that they reduce hospital mortality in any patient subgroup. Given the potential dangers, widespread use, and uncertainty about consequences of arterial catheter use in ICUs, equipoise exists and randomized trials are needed. Multiple studies in different, well-characterized, patient subgroups are needed to clarify whether arterial catheters influence outcomes. These studies should assess the range of relevant outcomes, including mortality, medical resource use, patient comfort, complications, and costs.
Allan Garland
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  146     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1155-8     Citation Subset:  AIM; IM    
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