Accessing Femoral Arteries Less than 3 mm in Diameter is Associated with Increased Incidence of Loss of Pulse Following Cardiac Catheterization in Infants
| Autor: | B. Rush Waller, Sachin D. Tadphale, Vijaykumar Agrawal, Shyam Sathanandam, Vinod Maller, Travis Kauffmann, Hannah Lloyd, Thomas Yohannan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Femoral artery 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine.artery Humans Medicine Arterial Pressure Prospective Studies Risk factor Pulse Ultrasonography Interventional Cardiac catheterization business.industry Pulse (signal processing) Incidence Incidence (epidemiology) Ultrasound Infant Newborn Infant Vascular surgery Cardiac surgery Femoral Artery 030228 respiratory system Pediatrics Perinatology and Child Health Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pediatric Cardiology. 41:1058-1066 |
| ISSN: | 1432-1971 0172-0643 |
| Popis: | To evaluate whether avoidance of a risk factor associated with loss of pulse (LOP) following femoral artery (FA) catheterization in infants identified from previous study, was associated with decreased incidence of LOP during a prospective evaluation. Since initiation of routine ultrasound guided femoral arterial access (UGFAA) for infants undergoing catheterization in Jan 2003-Dec 2011 (Period-1), our incidence of LOP had stayed steady. Prospective evaluation between Jan 2012-Dec 2014 (Period-2), identified FA-diameter 3 mm as risk factor for LOP. Between Jan 2015-Dec 2018 (Period-3), an initiative to avoid UGFAA for FA-diameter 3 mm was implemented to determine whether that led to a decreased incidence of LOP. FA-diameter was measured prior to USGFAA and ratio of outer diameter of arterial sheath to luminal diameter of cannulated artery (OD/AD ratio) was calculated during Periods-2 and 3. The incidence and risk factors for LOP were assessed during the three periods. FA-access rates dropped significantly during Period-3 (56.7% vs. 93.8% and 90.4% during Periods-1 and 2, respectively, p 0.001). Incidence of LOP in Period-3 decreased to 2.7% compared to 12.5% (Period-1) and 17.4% (Period-2) (p 0.001). By multivariate analysis, FA size 3 mm and an OD/AD ratio 40% were the only significant independent predictors for LOP (OR 6.48, 95% CI 2.3-11.42, p 0.001 and OR 4.16, 95% CI 1.79-8.65, p 0.01, respectively). Access of femoral artery 3 mm and OD/AD ratio 50% are associated with increased incidence of LOP. Avoidance of these factors may help decrease complications in infants undergoing cardiac catheterizations. |
| Databáze: | OpenAIRE |
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