• Users Online: 276
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
Year : 2020  |  Volume : 7  |  Issue : 3  |  Page : 308-312

Ultrasound-guided arterial catheterization in critical patients with nonpulsatile continuous circulation conditions on ventricular assist devices or veno-arterial extracorporeal membrane oxygenation support

1 King Faisal Specialist Hospital & Research Center, Riyadh; Department of Critical Care, Cairo University, Cairo, Egypt, Saudi Arabia
2 King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

Correspondence Address:
MD,PhD Mohamed Laimoud
King Faisal Heart Center, P.O Box 3354, Riyadh 11211
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_102_19

Rights and Permissions

Background Arterial catheterizations, especially of radial and femoral arteries, are very common procedures performed by physicians dealing with critical patients for invasive hemodynamic monitoring and frequent arterial blood sampling. Traditionally, the technique of locating surface landmarks and palpation was used in catheterization. Getting arterial access can be challenging in critical patients with hemodynamic instability, impalpable pulses, and coagulopathy. Our objective was to study the effectiveness of vascular ultrasound in arterial catheterization in critical patients with nonpulsatile circulation admitted at cardiac critical care units in comparison with the landmark technique. Patients, methods, and results This retrospective study was conducted in a tertiary care hospital and included patients from January 2015 to November 2018 who were admitted to adult cardiac critical care unit with veno-arterial extracorporeal membrane oxygenation or left ventricular assist device and required arterial vascular access for invasive hemodynamic monitoring. A total of 124 vascular catheters were inserted in 109 critical patients. Overall, 87 (79.8%) patients were hemodynamically unstable and supported with vasopressors infusions. Heparin infusion was maintained in 91 (83.4%) patients, while 18 (16.51%) patients were anticoagulated with oral warfarin therapy during arterial catheterization. The first-attempt success was achieved in 78.9 versus 5.6% (P=0.001) and the procedural success rate was 100 versus 62.1% (P=0.001) in the ultrasound and landmark groups, respectively. The number of attempts was 1.2±0.4 versus 2.1±0.5 (P=0.001), and the hematoma occurred in 2.8 versus 11.1% (P=0.001) in the ultrasound and landmark groups, respectively. Conclusion Ultrasound-guided arterial catheterization in critical patients with unstable hemodynamics and nonpulsatile continuous circulation was associated with higher first-attempt and procedural success and less complications compared with the landmark technique.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal