Arterial trauma due to central venous catheter insertion: an analysis of incidents reported to the National Reporting and Learning System for England and Wales 2013–2023
Authors' conclusion
Whilst some incidents involved potential risk factors (e.g. operator inexperience, landmark technique, paediatric lines and emergent insertion) arterial trauma nevertheless occurs when experienced operators undertake seemingly routine procedures.
Study context
- Population
- Incidents of arterial trauma from central venous catheter insertion (arterial insertion of a dilator or catheter; needle or guidewire puncture if moderate or severe harm), National Reporting and Learning System and Strategic Executive Information System, England and Wales, 10-year period
- Participants
- 241 arterial trauma incidents
- Outcome
- Characteristics and outcomes of arterial trauma incidents
Methodological detailstwo national incident-reporting databases, 10-year period
- Two national incident-reporting databases
- 10-year period
Main finding
As reported in the abstract
- Arterial trauma despite reassuring visual appearance of blood
- 35 (15%)
- Arterial trauma despite guidewire visualisation by ultrasound
- 53 (22%)
- Chest radiograph failed to identify arterial cannulation (cases of delayed recognition)
- 20 (27%)
- Strokes
- 24 (10%)
- Deaths
- 10 (4%)
Observational data: associations, not effects.
Further findings
Stroke risk factors (excluding femoral and peripherally-inserted catheters)
| RR (95% CI) | ||
|---|---|---|
| Delayed diagnosis | 3.57 (2.04–6.24) | |
| Arterial drug administration | 2.67 (1.48–4.82) | |
| 0.10.31310Relative risk (log scale) |
Outcomes despite immediate recognition of arterial trauma
- Stroke
- 8 (6%)
- Death
- 3 (2%)
Original publication
Arterial trauma due to central venous catheter insertion: an analysis of incidents reported to the National Reporting and Learning System for England and Wales 2013–2023. Anaesthesia. Published 20 February 2025. doi:10.
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