Slogoff S, Keats A S, Arlund C
Anesthesiology. 1983 Jul;59(1):42-7. doi: 10.1097/00000542-198307000-00008.
The frequency of complications following radial artery cannulation for monitoring purposes was determined in 1,699 cardiovascular surgical patients and in 83 patients in whom cannulation was performed in another artery after failure at the radial site. Patients were examined and radial artery flow determined by a Doppler technique 1 day and 7 days after decannulation. Although partial or complete radial artery occlusion after decannulation occurred in more than 25% of the patients, no ischemic damage to the hand or disability occurred in any patient. Neither duration of cannulation nor the size or material of the cannulas were determinants of abnormal flow. Abnormal flow was significantly related to female sex, the presence of hematoma, and to the use of extracorporeal circulation. The radial arteries of 16 patients whose results of Allen's test were abnormal were cannulated and no abnormal flow or ischemia followed. In 22 patients, the ulnar artery was cannulated after multiple punctures of the ipsilateral radial artery and no ischemia followed. We conclude that in the absence of peripheral vascular disease, the Allen's test is not a predictor of ischemia of the hand during or after radial artery cannulation, that when decreased or absent radial artery flow follows cannulation it is of no clinical consequence, and that radial artery cannulation is a low-risk high-benefit monitoring technique that deserves wide clinical use.
在1699例心血管外科手术患者以及83例桡动脉穿刺失败后改用其他动脉穿刺的患者中，确定了用于监测目的的桡动脉穿刺后并发症的发生率。在拔除插管后1天和7天，对患者进行检查，并采用多普勒技术测定桡动脉血流。尽管超过25%的患者在拔除插管后发生了部分或完全桡动脉闭塞，但没有任何患者出现手部缺血性损伤或功能障碍。插管持续时间、插管的尺寸或材料均不是异常血流的决定因素。异常血流与女性、血肿的存在以及体外循环的使用显著相关。对16例艾伦试验结果异常患者的桡动脉进行了穿刺，术后未出现异常血流或缺血情况。在22例患者中，同侧桡动脉多次穿刺失败后改用尺动脉穿刺，术后也未出现缺血情况。我们得出结论，在没有外周血管疾病的情况下，艾伦试验不能预测桡动脉穿刺期间或之后手部是否会发生缺血；当穿刺后桡动脉血流减少或消失时，并无临床意义；桡动脉穿刺是一种低风险、高收益的监测技术，值得在临床上广泛应用。
