Department of Critical Care Medicine, The Mount Sinai Hospital, New York, NY, USA.
Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
J Intensive Care Med. 2024 Sep;39(9):916-921. doi: 10.1177/08850666241257417. Epub 2024 May 25.
Arterial catheter placement for hemodynamic monitoring is commonly performed in critically ill patients. The radial and femoral arteries are the two sites most frequently used; there is limited data on the use of the axillary artery for this purpose. The aim of this study was to investigate the rate of complications from ultrasound-guided axillary artery catheter placement in critically ill patients.
A retrospective study at a tertiary care center of patients admitted to an intensive care unit who had ultrasound-guided axillary artery catheter placement during admission. Primary outcome of interest was catheter related complications, including bleeding, vascular complications, compartment syndrome, stroke or air embolism, catheter malfunction, and need for surgical intervention.
This study identified 88 patients who had an ultrasound-guided axillary artery catheter placed during their admission. Of these 88, nine patients required multiple catheters placed, for a total of 99 axillary artery catheter placement events. The median age was 64 [IQR 48, 71], 41 (47%) were female, and median body mass index (BMI) was 26 [IQR 22, 30]. The most common complication was minor bleeding (11%), followed by catheter malfunction (2%), and vascular complications (2%). Univariate analyses did not show any association between demographics and clinical variables, and complications related to axillary arterial catheter.
The most common complication found with ultrasound-guided axillary artery catheter placement was minor bleeding, followed by catheter malfunction, and vascular complications. Ultrasound-guided axillary arterial catheters are an alternative in patients in whom radial or femoral arterial access is difficult or not possible to achieve.
在危重病患者中，常进行动脉导管置管以进行血流动力学监测。桡动脉和股动脉是最常使用的两个部位；对于腋动脉在该目的下的使用，数据有限。本研究旨在调查超声引导下腋动脉导管置管在危重病患者中并发症的发生率。
对一家三级护理中心的患者进行回顾性研究，这些患者在入住重症监护病房期间接受了超声引导下腋动脉导管置管。主要观察结果是导管相关并发症，包括出血、血管并发症、间隔综合征、中风或空气栓塞、导管功能障碍和需要手术干预。
本研究确定了 88 例在住院期间接受超声引导下腋动脉导管置管的患者。在这 88 例患者中，有 9 例患者需要多次放置导管，总共进行了 99 次腋动脉导管置管操作。患者的中位年龄为 64 [IQR 48, 71]，41 例（47%）为女性，中位数体重指数（BMI）为 26 [IQR 22, 30]。最常见的并发症是轻微出血（11%），其次是导管功能障碍（2%）和血管并发症（2%）。单因素分析未显示人口统计学和临床变量与腋动脉导管相关并发症之间存在任何关联。
超声引导下腋动脉导管置管最常见的并发症是轻微出血，其次是导管功能障碍和血管并发症。在桡动脉或股动脉通路困难或不可能实现的情况下，超声引导下腋动脉导管是一种替代选择。
