Maruhashi Takaaki, Oi Marina, Hattori Jun, Asari Yasushi
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
J Vasc Access. 2025 Jan;26(1):168-174. doi: 10.1177/11297298231212393. Epub 2023 Nov 23.
To compare the distal radial artery approach (DRA) with a longer catheter to DRA with a shorter catheter in arterial catheter (AC) placement in the intensive care unit (ICU).
This was a single-center retrospective cohort study of DRA with a long catheter (60 mm) for arterial catheterization in the ICU. DRA with a short catheter (25-30 mm) was used in the control group, and the groups were compared using multivariate regression analysis. The primary study endpoint was the incidence of unplanned AC removal. The secondary endpoint was the incidence of other inappropriate events, namely loss of arterial pressure waveforms, bleeding, catheter-related infection, pressure ulcer, and other complications associated with the AC.
In this study, the DRA with a long catheter was used in 50 patients. No unplanned AC removals or other inappropriate events occurred, and there were no complications associated with the DRA. The DRA procedural success rate was 100%. There was no significant difference in hemostasis times between the groups. Loss of arterial waveforms was an early predictor of unplanned AC removal.
The DRA with a long catheter provided stable monitoring and was associated with a low unplanned removal rate. This method has the advantages of fewer complications and shorter hemostasis time compared with the DRA with a short catheter, and may become a new AC option in the ICU.
在重症监护病房(ICU)进行动脉导管(AC)置入时,比较使用较长导管的桡动脉远端入路(DRA)与使用较短导管的DRA。
这是一项单中心回顾性队列研究,研究对象为在ICU使用长导管(60毫米)进行动脉导管插入术的DRA。对照组使用短导管(25 - 30毫米)的DRA,采用多变量回归分析对两组进行比较。主要研究终点是计划外AC拔除的发生率。次要终点是其他不当事件的发生率,即动脉压波形消失、出血、导管相关感染、压疮以及与AC相关的其他并发症。
在本研究中,50例患者使用了长导管的DRA。未发生计划外AC拔除或其他不当事件,且未出现与DRA相关的并发症。DRA操作成功率为100%。两组之间止血时间无显著差异。动脉波形消失是计划外AC拔除的早期预测指标。
使用长导管的DRA提供了稳定的监测,且计划外拔除率较低。与使用短导管的DRA相比,该方法具有并发症更少、止血时间更短的优点,可能成为ICU中AC的一种新选择。