Femoral artery cannulation for arterial pressure measurement in the intensive care unit: current evidence and description of the technique.

Arterial cannulation for arterial line placement is a common procedure in critically ill patients. The radial artery is usually cannulated for this purpose, but in excessive vaso-constriction or shock, this approach may be inaccessible. In such cases, the femoral artery is frequently selected for the placement of an arterial catheter. Given this, the low number of clinical trials conducted in intensive care concerning femoral artery cannulation is surprising. The femoral approach is particularly useful in patients who require hemodynamic monitoring using transpulmonary thermodilution and fluid responsiveness tests. Arterial catheters inserted through the femoral artery are considered more durable than those placed in the radial artery. In addition, arterial pressure has higher values when measured in the femoral artery than in the radial artery. This narrative review presents current evidence on percutaneous cannulation of the common femoral artery for arterial pressure measurement in critically ill patients. The cannulation techniques are described with their limitations and contraindications. In addition, practical tips that may be useful in daily practice, and some potential pitfalls, are also presented.