Anesthesiology. 2021 Jan 1;134(1):26-34. doi: 10.1097/ALN.0000000000003594.
Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of major short-term complications associated with arterial cannulation for perioperative monitoring in children, and (2) describe the rates of major complications by anatomical site and age category of the patient.
The authors examined a retrospective cohort of pediatric patients (age less than 18 yr) undergoing surgical procedures at a single academic medical center from January 1, 2006 to August 15, 2016. Institutional databases containing anesthetic care, arterial cannulation, and postoperative complications information were queried to identify vascular, neurologic, and infectious short term complications within 30 days of arterial cannulation.
There were 5,142 arterial cannulations performed in 4,178 patients. The most common sites for arterial cannulation were the radial (N = 3,395 [66.0%]) and femoral arteries (N = 1,528 [29.7%]). There were 11 major complications: 8 vascular and 3 infections (overall incidence, 0.2%; rate, 2 per 1,000 lines; 95% CI, 1 to 4) and all of these complications were associated with femoral arterial lines in children younger than 5 yr old (0.7%; rate, 7 per 1,000 lines; 95% CI, 4 to 13). The majority of femoral lines were placed for cardiac procedures (91%). Infants and neonates had the greatest complication rates (16 and 11 per 1,000 lines, respectively; 95% CI, 7 to 34 and 3 to 39, respectively).
The overall major complication rate of arterial cannulation for monitoring purposes in children is low (0.2%). All complications occurred in femoral arterial lines in children younger than 5 yr of age, with the greatest complication rates in infants and neonates. There were no complications in distal arterial cannulation sites, including more than 3,000 radial cannulations.
儿童围术期动脉置管术常规进行。基于对与股动脉置管相关的几种并发症的临床观察，作者进行了一项更大规模的研究，以进一步检查并发症。作者旨在：(1)描述与儿童围术期监测的动脉置管相关的主要短期并发症的使用模式和发生率；(2)按患者的解剖部位和年龄类别描述主要并发症的发生率。
作者检查了 2006 年 1 月 1 日至 2016 年 8 月 15 日在一家学术医疗中心接受手术的小儿患者（年龄小于 18 岁）的回顾性队列。查询包含麻醉护理、动脉置管和术后并发症信息的机构数据库，以确定 30 天内与动脉置管相关的血管、神经和感染性短期并发症。
共有 4178 名患者进行了 5142 次动脉置管。最常见的动脉置管部位是桡动脉（N=3395[66.0%]）和股动脉（N=1528[29.7%]）。有 11 例主要并发症：8 例血管并发症和 3 例感染（总发生率 0.2%；发生率为每 1000 条导管 2 条；95%CI，1 至 4），所有这些并发症均与 5 岁以下儿童的股动脉置管有关（0.7%；发生率为每 1000 条导管 7 条；95%CI，4 至 13）。大多数股动脉导管是为心脏手术放置的（91%）。婴儿和新生儿的并发症发生率最高（每 1000 条导管分别为 16 和 11 例；95%CI，分别为 7 至 34 和 3 至 39）。
儿童监测目的的动脉置管术的总体主要并发症发生率较低（0.2%）。所有并发症均发生在 5 岁以下儿童的股动脉置管中，婴儿和新生儿的并发症发生率最高。在包括 3000 多次桡动脉置管在内的远端动脉置管部位均无并发症。
