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A comparison of arterial lines and insertion techniques in critically ill patients
Author(s) -
BEARDS S. C.,
DOEDENS L.,
JACKSON A.,
LIPMAN J.
Publication year - 1994
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1994.tb04316.x
Subject(s) - medicine , seldinger technique , catheter , critically ill , arterial line , arterial catheter , surgery , anesthesia
Summary We compared three arterial line insertion techniques and two types of arterial catheters in 69 critically ill patients. Use of the direct‐puncture technique (method A) was associated with a significantly higher failure rate (23%) than use of a catheter with a separate guide wire (method B,‘classical’Seldinger technique, p < 0.001) or a catheter with an integral guide wire (method C,‘modified’Seldinger technique, p < 0.02). Operators randomly allocated to using method A took significantly longer to perform the procedure than those using method C (p < 0.01), used significantly more catheters (p < 0.0001) and made significantly more punctures in achieving a successful insertion than those using either methods B (p < 0.001) or C (p < 0.001). Both catheter types B and C (polyurethane) were significantly less likely to block, thus requiring re‐insertion, than catheter type A (Teflon) (p < 0.02, p < 00 01 respectively). We recommend the use of a‘classical’Seldinger technique (method B) for arterial line insertion in critically ill patients and the use of a polyurethane catheter, in preference to Teflon, to maximise catheter life after insertion.