Complications related to less-invasive haemodynamic monitoring

The aim of this study was to evaluate the type and incidence of complications during insertion, maintenance, and withdrawal of central arterial catheters used for transpulmonary thermodilution haemodynamic monitoring (PiCCO™). We conducted a prospective, observational, multicentre study in 14 Europe...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 2011-04, Vol.106 (4), p.482-486
Main Authors: Belda, F.J., Aguilar, G., Teboul, J.L., Pestaña, D., Redondo, F.J., Malbrain, M., Luis, J.C., Ramasco, F., Umgelter, A., Wendon, J., Kirov, M., Fernández-Mondéjar, E.
Format: Article
Language:English
Subjects:
Adult
Aged
arteries, cannulation
Cardiac Catheterization - adverse effects
Cardiac Catheterization - instrumentation
Cardiac Output
complications
Critical Care - methods
Device Removal - adverse effects
Female
Humans
Male
Middle Aged
monitoring, cardiopulmonary
Monitoring, Physiologic - adverse effects
Monitoring, Physiologic - methods
Prospective Studies
Thermodilution - adverse effects
Thermodilution - instrumentation
Thermodilution - methods
Young Adult
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Summary:The aim of this study was to evaluate the type and incidence of complications during insertion, maintenance, and withdrawal of central arterial catheters used for transpulmonary thermodilution haemodynamic monitoring (PiCCO™). We conducted a prospective, observational, multicentre study in 14 European intensive care units (six countries). A total of 514 consecutive patients in whom haemodynamic monitoring by PiCCO™ was indicated were studied. Five hundred and fourteen PiCCO catheters (475 in femoral, 26 in radial, nine in axillary, and four in brachial arteries) were inserted. Arterial access was obtained on the first attempt in 86.4% of the patients. Minor problems such as oozing after insertion (3.3%) or removal of the catheter (3.5%) were observed, but no episodes of serious bleeding (more than 50 ml) were recorded. Small local haematomas were observed after insertion (4.5%) and after removal (1.2%) of the catheter. These complications were not more frequent in patients with coagulation abnormalities. The incidence of site inflammation and catheter-related infection was 2% and 0.78%, respectively. Other complications such as ischaemia (0.4%), pulse loss (0.4%), or femoral artery thrombosis (0.2%) were rare, transient, and all resolved with catheter removal or embolectomy, respectively. In this series of patients, central arterial catheters used for PiCCO™ monitoring were demonstrated to be a safe alternative for advanced haemodynamic monitoring.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/aeq377