Arterial catheter placement & Care: Difference between revisions

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Relevant Article Depot:

Evaluation of the factors related to difficult ultrasound-guided radial artery catheterization in small children: A prospective observational study

Guía práctica para la colocación ecográfica de accesos venosos y arteriales en pediatría. Recomendaciones GAVA (Practical guide for ultrasound-guided placement of venous and arterial access in pediatrics) GAVA Recommendations

Immediate complications and risk factors following radial arterial catheterisation in paediatric patients at a tertiary centre

Cochrane Database of Systematic Reviews: Ultrasound‐guided arterial cannulation for paediatrics

Cochrane Database of Systematic Reviews: Heparin versus normal saline for patency of arterial lines

Tweet by Adrian Wong @avkwong Anyone use this technique regularly?

Tweet by Mark Ramzy, DO, EMT-P @MRamzyDO KNOW YOUR A-LINE!

Arterial Pressure Monitoring

"Arterial Line Placement" by James DiNardo, MD, FAAP for OPENPediatrics

The ulnar artery: a site suitable for arterial cannulation in pediatric patients. Pediatric ulnar and radial artery sizes

Modified Long-Axis In-Plane Ultrasound-guided Radial Artery Cannulation In Adult Patients: A Randomized Controlled Trial

Evaluation of distal radial artery cross-sectional internal diameter in neonates and infants by ultrasound and adequate selection of an intra-arterial catheter size

Can the ulnar artery serve as an alternative option for arterial cannulation in neonates?

Intraarterial Papaverine For Relief of Catheter Induced Peripheral Arterial Vasospasm During Pediatric Cardiac Surgery: A Randomized Double-Blind Controlled Trial

Test Your Knowledge-TYK29

Invasive arterial pressure monitoring: much more than mean arterial pressure!

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Baby-Blocks: Arterial Access at the Wrist

Alternative arterial catheterization site using the ulnar artery in critically ill pediatric patients

Deferring Arterial Catheterization in Critically Ill Patients with Shock

Intravenous access and blood pressure monitoring in patients with previous axillary nodal dissection

BabyBlocks: Arterial Access at the Wrist: Ultrasound vs. Palpation

Comparison of Single-operator Laser-assisted Ultrasound-guided Radial Arterial Cannulation in Young Children with Traditional Ultrasound Guidance: A Randomized Clinical Trial

Arterial fast bolus flush systems used routinely in neonates and infants cause retrograde embolization of flush solution into the central arterial and cerebral circulation

Prevention of cerebral embolization from flushing radial-artery cannulas

Neurologic complications following temporal artery catheterization

WFSA: ATOTW 498: Management of Accidental Intra-Arterial Injections

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Comparison of radial, dorsalis pedis, and posterior tibial arteries for ultrasound-guided arterial catheterisation with dynamic needle tip positioning in paediatric patients: a randomised controlled trial

The ulnar artery: a site suitable for arterial cannulation in pediatric patients

Ultrasound-guided dynamic needle tip positioning versus conventional palpation approach for catheterisation of posterior tibial or dorsalis pedis artery in infants and small children

Major short-term complications of arterial cannulation for monitoring in children

The use of invasive arterial blood pressure monitoring in routine anaesthesia practice: an analysis from the NAP7 project

Acid-Base Interpretation: A Practical Approach

Arterial lines: is the pulse still strong?

Challenging the default use of arterial catheters in critical care

Central Artery Access

Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience

Warning: serious sequelae of temporal artery catheterization

Prevention of cerebral embolization from flushing radial-artery cannulas

Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Axillary arterial monitoring of pediatric patients

Cannulation of the axillary artery in critically ill newborn infants

SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access and Training

Biais M, Ehrmann S, Mari A, et al. Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach. Crit Care. 2014;18(6):587. Published 2014 Nov 4. doi:10.1186/s13054-014-0587-9

Pilarz MS, Mattson CD, Pritchett CM, Rountree AK, Rowland MJ. Practice Variation in Arterial Catheter Placement: A Survey of Pediatric Critical Care Practitioners. J Intensive Care Med. Published online September 1, 2025. doi:10.1177/08850666251363551

Gershengorn HB, Wunsch H, Scales DC, Zarychanski R, Rubenfeld G, Garland A. Association between arterial catheter use and hospital mortality in intensive care units. JAMA Intern Med. 2014;174(11):1746-1754. doi:10.1001/jamainternmed.2014.3297

Sionis A, Rivas-Lasarte M, Mebazaa A, et al. Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study. J Intensive Care Med. 2020;35(12):1426-1433. doi:10.1177/0885066619828959

Gleich SJ, Wong AV, Handlogten KS, Thum DE, Nemergut ME. Major Short-term Complications of Arterial Cannulation for Monitoring in Children. Anesthesiology. 2021;134(1):26-34. doi:10.1097/ALN.0000000000003594

Allen’s Test

Thromboangiitis Obliterans: Methods of Diagnosis of Chronic Occlusive Arterial Lesions Distal to the Wrist With Illustrative Cases (1929)

Incorrect performance of Allen’s Test-Ulnar Artery Flow Erroneously Presumed Inadequate

Complications of Percutaneous Radial-artery Cannulation: An Objective Prospective Study in Man

Evaluation of collateral circulation of the hand

Comparison of radial, dorsalis pedis, and posterior tibial arteries for ultrasound-guided arterial catheterisation with dynamic needle tip positioning in paediatric patients: a randomised controlled trial

Vascular Catheterization is Difficult in Infants with Down Syndrome

Abnormal radial artery in Down's syndrome

@@ Line 2: / Line 2: @@
 [https://onlinelibrary.wiley.com/doi/epdf/10.1111/aas.13704?saml_referrer Evaluation of the factors related to difficult ultrasound-guided radial artery catheterization in small children: A prospective observational study]
+[https://www.criticalcareandemergencymedicine.com/wp-content/uploads/2026/01/Guia-practica-para-la-colocacion-ecografica-16-01-1.html Guía práctica para la colocación ecográfica de accesos venosos y arteriales en pediatría. Recomendaciones GAVA (Practical guide for ultrasound-guided placement of venous and arterial access in pediatrics) GAVA Recommendations]
+[https://pubmed.ncbi.nlm.nih.gov/40923190/ Immediate complications and risk factors following radial arterial catheterisation in paediatric patients at a tertiary centre]
 [https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011364.pub2/full Cochrane Database of Systematic Reviews: Ultrasound‐guided arterial cannulation for paediatrics]
@@ Line 25: / Line 29: @@
 [https://pubmed.ncbi.nlm.nih.gov/35304932/ Intraarterial Papaverine For Relief of Catheter Induced Peripheral Arterial Vasospasm During Pediatric Cardiac Surgery: A Randomized Double-Blind Controlled Trial]
-[https://www.pedsanesthesia.net/wiki/index.php?title=TYK29 TYK29]
+[https://www.pedsanesthesia.net/wiki/index.php?title=TYK29 Test Your Knowledge-TYK29]
 [https://link.springer.com/article/10.1007/s00134-022-06798-8 Invasive arterial pressure monitoring: much more than mean arterial pressure!]
@@ Line 34: / Line 38: @@
 [https://pubmed.ncbi.nlm.nih.gov/12780957/ Alternative arterial catheterization site using the ulnar artery in critically ill pediatric patients]
+[https://www.nejm.org/doi/full/10.1056/NEJMoa2502136 Deferring Arterial Catheterization in Critically Ill Patients with Shock]
 [https://www.anzca.edu.au/resources/professional-documents/professional-document-appendix-topics/appendix-1-pg18(a).pdf Intravenous access and blood pressure monitoring in patients with previous axillary nodal dissection]
@@ Line 50: / Line 56: @@
 [https://pubmed.ncbi.nlm.nih.gov/33079134/  Major Short-term Complications of Arterial Cannulation for Monitoring in Children]
-Zaleski KL, Kuntz MT, Staffa SJ, Van Pelt H, Hamilton ARL, Atkinson DB. Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience. Anesthesia and analgesia 2024 (In eng). DOI: 10.1213/ane.0000000000006972.
 [https://pubmed.ncbi.nlm.nih.gov/37604735/ Comparison of radial, dorsalis pedis, and posterior tibial arteries for ultrasound-guided arterial catheterisation with dynamic needle tip positioning in paediatric patients: a randomised controlled trial]
-Roux J, Kohn MA, Sinskey J, Nguyen H, Boor M, Rouine-Rapp K. The ulnar artery: a site suitable for arterial cannulation in pediatric patients. Paediatr Anaesth. 2021 Dec; 31(12): 1357-1363. PMID: 34644423
+[https://pubmed.ncbi.nlm.nih.gov/34644423/  The ulnar artery: a site suitable for arterial cannulation in pediatric patients]
-Takeshita J, Tachibana K, Nakayama Y, et al. Ultrasound-guided dynamic needle tip positioning versus conventional palpation approach for catheterisation of posterior tibial or dorsalis pedis artery in infants and small children. Br J Anaesth. 2021 Apr; 126(4): e140-e142. PMID: 33358049
+[https://pubmed.ncbi.nlm.nih.gov/33358049/  Ultrasound-guided dynamic needle tip positioning versus conventional palpation approach for catheterisation of posterior tibial or dorsalis pedis artery in infants and small children]
-Gleich SJ, Wong AV, Handlogten KS, Thum DE, Nemergut ME. Major short-term complications of arterial cannulation for monitoring in children. Anesthesiology. 2021 Jan; 134(1): 26-34. PMID: 33079134
+[https://pubmed.ncbi.nlm.nih.gov/33079134/  Major short-term complications of arterial cannulation for monitoring in children]
 [https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16679 The use of invasive arterial blood pressure monitoring in routine anaesthesia practice: an analysis from the NAP7 project]
 [https://pubmed.ncbi.nlm.nih.gov/39964926/ Acid-Base Interpretation: A Practical Approach]
+[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70099 Arterial lines: is the pulse still strong?]
+[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70119 Challenging the default use of arterial catheters in critical care]
 <b>Central Artery Access</b>
-Zaleski KL, Kuntz MT, Staffa SJ, Van Pelt H, Hamilton ARL, Atkinson DB. Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience. Anesthesia and analgesia 2024 (In eng). DOI: 10.1213/ane.0000000000006972.
+[https://pubmed.ncbi.nlm.nih.gov/38935540/ Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience]
+[https://pubmed.ncbi.nlm.nih.gov/621610/ Warning: serious sequelae of temporal artery catheterization]
+[https://pubmed.ncbi.nlm.nih.gov/5121208/ Prevention of cerebral embolization from flushing radial-artery cannulas]
+[https://pubmed.ncbi.nlm.nih.gov/33079134/ Major Short-term Complications of Arterial Cannulation for Monitoring in Children]
+[https://pubmed.ncbi.nlm.nih.gov/2748255/ Axillary arterial monitoring of pediatric patients]
-Simmons MA, Levine RL, Lubchenco LO, Guggenheim MA. Warning: serious sequelae of temporal artery catheterization. The Journal of pediatrics 1978;92(2):284. (In eng). DOI: 10.1016/s0022-3476(78)80027-4.
+[https://pubmed.ncbi.nlm.nih.gov/7895757/ Cannulation of the axillary artery in critically ill newborn infants]
-Lowenstein E, Little JW, 3rd, Lo HH. Prevention of cerebral embolization from flushing radial-artery cannulas. The New England journal of medicine 1971;285(25):1414-5. (In eng). DOI: 10.1056/nejm197112162852506.
+[https://pubmed.ncbi.nlm.nih.gov/39131962/ SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access and Training]
-Gleich SJ, Wong AV, Handlogten KS, Thum DE, Nemergut ME. Major Short-term Complications of Arterial Cannulation for Monitoring in Children. Anesthesiology 2021;134(1):26-34. (In eng). DOI: 10.1097/aln.0000000000003594.
+Biais M, Ehrmann S, Mari A, et al. Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach. Crit Care. 2014;18(6):587. Published 2014 Nov 4. doi:10.1186/s13054-014-0587-9
-Lawless S, Orr R. Axillary arterial monitoring of pediatric patients. Pediatrics 1989;84(2):273-5. (In eng).
+Pilarz MS, Mattson CD, Pritchett CM, Rountree AK, Rowland MJ. Practice Variation in Arterial Catheter Placement: A Survey of Pediatric Critical Care Practitioners. J Intensive Care Med. Published online September 1, 2025. doi:10.1177/08850666251363551
-Piotrowski A, Kawczynski P. Cannulation of the axillary artery in critically ill newborn infants. European journal of pediatrics 1995;154(1):57-9. (In eng). DOI: 10.1007/bf01972974.
+Gershengorn HB, Wunsch H, Scales DC, Zarychanski R, Rubenfeld G, Garland A. Association between arterial catheter use and hospital mortality in intensive care units. JAMA Intern Med. 2014;174(11):1746-1754. doi:10.1001/jamainternmed.2014.3297
-Seto AH, Estep JD, Tayal R, et al. SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access and Training. J Soc Cardiovasc Angiogr Interv 2022;1(3):100041. (In eng). DOI: 10.1016/j.jscai.2022.100041.
+Sionis A, Rivas-Lasarte M, Mebazaa A, et al. Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study. J Intensive Care Med. 2020;35(12):1426-1433. doi:10.1177/0885066619828959
+Gleich SJ, Wong AV, Handlogten KS, Thum DE, Nemergut ME. Major Short-term Complications of Arterial Cannulation for Monitoring in Children. Anesthesiology. 2021;134(1):26-34. doi:10.1097/ALN.0000000000003594
 <b>Allen’s Test</b>
-Allen EV. Thromboangiitis Obliterans: Methods of Diagnosis of Chronic Occlusive Arterial Lesions Distal to the Wrist With Illustrative Cases. Am J Med Sci. 1929; 178(2): 237-243
+[https://pubmed.ncbi.nlm.nih.gov/19312256/ Thromboangiitis Obliterans: Methods of Diagnosis of Chronic Occlusive Arterial Lesions Distal to the Wrist With Illustrative Cases (1929)]
+[https://pubmed.ncbi.nlm.nih.gov/5051612/ Incorrect performance of Allen’s Test-Ulnar Artery Flow Erroneously Presumed Inadequate]
-Greenhow DE. Incorrect performance of Allen’s Test-Ulnar Artery Flow Erroneously Presumed Inadequate. Anesthesiology 1972; 37(3): 356-357
+[https://pubmed.ncbi.nlm.nih.gov/4698143/ Complications of Percutaneous Radial-artery Cannulation: An Objective Prospective Study in Man]
-Bedford RF, Wollman H. Complications of Percutaneous Radial-artery Cannulation: An Objective Prospective Study in Man. Anesthesiology 1973; 38(3): 228-236
+[https://pubmed.ncbi.nlm.nih.gov/1538249/ Evaluation of collateral circulation of the hand]
-TM, Pippin WD, Talmage LA, Reilley TE. Evaluation of collateral circulation of the hand. J Clin Monit 1992; 8: 28-32
+[https://pubmed.ncbi.nlm.nih.gov/37604735/ Comparison of radial, dorsalis pedis, and posterior tibial arteries for ultrasound-guided arterial catheterisation with dynamic needle tip positioning in paediatric patients: a randomised controlled trial]
+[https://pubmed.ncbi.nlm.nih.gov/19032563/ Vascular Catheterization is Difficult in Infants with Down Syndrome]
 [https://pubmed.ncbi.nlm.nih.gov/2945516/ Abnormal radial artery in Down's syndrome]
-Comparison of radial, dorsalis pedis, and posterior tibial arteries for ultrasound-guided arterial catheterisation with dynamic needle tip positioning in paediatric patients: a randomised controlled trial.
-Takeshita J, et.al. Br J Anaesth 2023:131:739-744.
-Vascular Catheterization is Difficult in Infants with Down Syndrome
-Sulemanji DS. Acta Anaesthesiol Scand, 2009:53:98-100