Cardiothoracic & vascular anaesthesia
Hemodynamic Monitoring In The Cardiac Surgical Patient: Comparison of Three Arterial Catheters
Authors' conclusion
Regarding CA-P SAP gradients, the RL group performed equally to the BL group, both being superior to RS. Regarding CA-P MAP gradients, BL was superior to RL and RS.
Study context
- Population
- Adults ≥18 years undergoing nonemergent cardiac surgery with cardiopulmonary bypass (CPB)after exclusions
- Participants
- 66 / 61 / 67
- Comparison
- Radial long vs brachial long vs radial short arterial catheter
- Radial Short (RS)n = 66reference
- Radial Long (RL)n = 61
- Brachial Long (BL)n = 67
- Primary endpoint
- Central aortic–peripheral catheter (CA-P) SAP and MAP gradients
- Follow-up
- Before CPB and 2 and 10 minutes after separation from CPB
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Primary result
As reported in the abstract
CA-P SAP gradient · 2 minutes after CPB
- CA-P SAP gradient significant for RS
- p = 0.005
- CA-P SAP gradient insignificant for BL
- p = 0.47
- CA-P SAP gradient insignificant for RL
- p = 0.39
Further findings
Femoral arterial line placement
| Outcome | P value |
|---|---|
| CA-P MAP gradient · 2 minutes after CPBBrachial Long (BL) vs Radial Long (RL) · lower in BL | P = 0.054 |
| CA-P MAP gradient · 2 minutes after CPBBrachial Long (BL) vs Radial Short (RS) · lower in BL | P < 0.05 |
| CA-P MAP gradient · 10 minutes after CPBRadial Long (RL) and Radial Short (RS) vs Brachial Long (BL) · both greater than BL | P = 0.002 |
- CA-P MAP gradient — Gradient significant for BL
- p = 0.003
- CA-P MAP gradient — Gradient significant for RL
- p < 0.0001
- CA-P MAP gradient — Gradient significant for RS
- p < 0.0001
- CA-P MAP gradient — Gradients in RL and RS remained significant
- p < 0.0001
CA-P SAP gradient · 10 minutes after CPB
- RS gradient remained significant, similar to 2 minutes
- P = 0.004
- Gradient increase from 2 to 10 minutes, BL
- P = 0.13
- Gradient increase from 2 to 10 minutes, RL
- P = 0.06
Vasopressin administration
- Significantly more frequent in RS
Original publication
Hemodynamic Monitoring In The Cardiac Surgical Patient: Comparison of Three Arterial Catheters. J Cardiothorac Vasc Anesth. Published 13 February 2024. doi:10.
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