Exploring Arterial Catheter Failures: Insights from a Multi-Center Study

Arterial catheters (ACs) are vital tools for monitoring hemodynamics and blood sampling in intensive care units (ICUs). However, they are also prone to complications. A recent secondary analysis of a multi-center randomized controlled trial delved into the incidence, risk factors, and types of AC failures, shedding light on critical aspects of ICU patient care.

Study Overview

The study analyzed data from 664 adult ICU patients with ACs, focusing on all-cause device failure as the primary outcome. Secondary outcomes included catheter-associated bloodstream infection (CABSI), occlusion, thrombosis, accidental removal, pain, and line fracture. Risk factors associated with AC failure were investigated using statistical models.

Key Findings

Among the findings, 26% of patients experienced AC failure, with suspected CABSI being the most common type. Ultrasound-assisted insertion significantly reduced all-cause failure and occlusion rates. Interestingly, older age groups showed lower AC failure rates, while females experienced more occlusion. Patients with diabetes, however, had fewer failures. Suspected CABSI was linked to abnormal insertion site appearances.

Implications

The study highlights the importance of utilizing ultrasound-guided insertion techniques to reduce AC failures in ICU settings. Understanding risk factors such as age, gender, and medical conditions like diabetes can aid in targeted interventions to improve catheter outcomes. Additionally, recognizing abnormal insertion site appearances can help in early detection and prevention of CABSI.

Conclusion

AC failures are not uncommon in ICUs, but strategies like ultrasound-guided insertion can significantly lower their incidence. This research underscores the need for evidence-based practices and tailored approaches to catheter management, ultimately enhancing patient safety and quality of care.

Read More: https://pubmed.ncbi.nlm.nih.gov/38459599/ 

Authors: Jessica A Schults, Emily R Young, Nicole Marsh, Emily Larsen, Amanda Corley, Robert S Ware, Marghie Murgo, Evan Alexandrou, Matthew McGrail, John Gowardman, Karina R Charles, Adrian Regli, Hideto Yasuda, Claire M Rickard; RSVP Study Investigators