Cardiothoracic & vascular anesthesia
Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience
Authors' conclusion
Axillary arterial access is associated with a lower rate of complications in pediatric patients undergoing cardiac surgery as compared to femoral arterial access. Serious complications are rare and were limited to femoral arterial lines in this study.
Study context
- Population
- Pediatric patients undergoing cardiac surgery with intraoperative axillary or femoral arterial line, July 1, 2012 to June 30, 2022
- Participants
- 1,263 central arterial lines
- Exposure
- Axillary vs femoral central arterial line
- Axillaryn = 195
- Femoraln = 1,068reference
- Outcome
- Incidence of complications (vascular compromise, pulse loss, ultrasound-confirmed thrombus or flow abnormality, and/or positive blood cultures not attributable to another source)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Overall vascular compromise
17.8%
Overall pulse loss
8.3%
Observational data: associations, not effects.
Further findings
Independent risk factors for vascular compromise (multivariate logistic regression)
| OR (95% CI) | ||
|---|---|---|
| Femoral location | 4.16 (1.97–8.78) | |
| Genetic syndrome | 1.68 (1.21–2.34) | |
| Prematurity | 1.48 (1.02–2.15) | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | OR (per hour) (95% CI) | |
|---|---|---|
| Independent risk factors for vascular compromise (multivariate logistic regression)Anesthesia time | 1.17 (1.07–1.27) | |
| 0.512Odds ratio (log scale) |
Independent risk factors for pulse loss (multivariate logistic regression)
| OR (95% CI) | ||
|---|---|---|
| Femoral location | 7.43 (2.08–26.6) | |
| Genetic syndrome | 1.86 (1.18–2.93) | |
| Prematurity | 1.65 (1.02–2.67) | |
| 22-G catheter size | 3.26 (1.16–9.15) | |
| 0.050.21520Odds ratio (log scale) |
Complications by age
- Complications more common in neonates and infants
Original publication
Central Arterial Line Placement for Pediatric Cardiac Surgery: A Single-Center Experience. Anesth Analg. Published 27 June 2024. doi:10.
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