The journal of vascular access · 2022
Severe ischemia after radial artery catheterization: A literature review of published cases.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ying Ying, Lin Xian-Ju, Chen Min-Juan, Cao Yan, Yao Yun-Tai, Evidence In Cardiovascular Anesthesia (EICA) Group
Аннотация
INTRODUCTION: Severe ischemia is a rare complication of radial artery catheterization (RAC). This study aims to summarize risk factors of RAC-elicited severe hand ischemia, preventive, and therapeutic management.
METHODS: Literature search was conducted in eight electronic English and Chinese databases to identify relevant published cases. Data of interest was extracted and analyzed.
RESULTS: Database search identified 28 articles reporting cases of 57 patients developing hand ischemia following RAC. Patients aged between 1 day and 88 years. The indications for RAC included surgery, shock, cardiac arrest, and Neonatal Intensive Care Unit (NICU) admission. Identified risk factors included pre-existing vascular diseases, hypotension, arterial anatomical abnormality or small diameter, vasoconstrictors, and catheter-related problems. Totally, 18 patients complained pain; 32 developed discoloration; 19 pulselessness; 3 paresthesia; 13 swolleness and 19 coldness. Eventually, 30 patients recovered well, but 20 patients unfortunately underwent digital amputation and three patients deceased due to non-RAC-related causes.
CONCLUSION: Severe hand ischemia following RAC is a rare complication, with the reported incidence of approximately 0.09%. There is no definite predictor for RAC-related hand ischemia, but patients with risk factors are prone to the occurrence of hand ischemia. It's vital to initiate early recognition and proactive strategies for a best practice RAC insertion.
METHODS: Literature search was conducted in eight electronic English and Chinese databases to identify relevant published cases. Data of interest was extracted and analyzed.
RESULTS: Database search identified 28 articles reporting cases of 57 patients developing hand ischemia following RAC. Patients aged between 1 day and 88 years. The indications for RAC included surgery, shock, cardiac arrest, and Neonatal Intensive Care Unit (NICU) admission. Identified risk factors included pre-existing vascular diseases, hypotension, arterial anatomical abnormality or small diameter, vasoconstrictors, and catheter-related problems. Totally, 18 patients complained pain; 32 developed discoloration; 19 pulselessness; 3 paresthesia; 13 swolleness and 19 coldness. Eventually, 30 patients recovered well, but 20 patients unfortunately underwent digital amputation and three patients deceased due to non-RAC-related causes.
CONCLUSION: Severe hand ischemia following RAC is a rare complication, with the reported incidence of approximately 0.09%. There is no definite predictor for RAC-related hand ischemia, but patients with risk factors are prone to the occurrence of hand ischemia. It's vital to initiate early recognition and proactive strategies for a best practice RAC insertion.