Arterial access

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Puncture cannula (above), Seldinger wire (middle) and arterial catheter (below)

The arterial access is primarily used for intravascular, continuous blood pressure measurement , for taking arterial blood for laboratory and blood gas analyzes and for inserting instruments (e.g. for cardiac catheter examinations ).

indication

Indications for an arterial puncture are:

  • Hemodynamic monitoring in hemodynamically unstable patients
  • Catecholamine therapy
  • increased intracerebral pressure (to determine the cerebral perfusion pressure)
  • Ventilation (frequent blood sampling for blood gas analysis)

Contraindication

Contraindications for an arterial puncture are:

technology

For the puncture, special indwelling arterial catheters are used, which are similar to peripheral venous catheters . As an alternative or for accesses with a larger diameter, which serve as locks for introducing instruments, for example for cardiac catheter examinations, arteries are usually punctured using the Seldinger technique under sterile conditions . It may be necessary to visualize the vessels using ultrasound . After the arterial access has been removed, sufficient compression of the puncture site must be ensured so that the bleeding is stopped quickly.

Localizations

The first choice sites for arterial access are:

Second choice locations are:

Complications

Possible complications of arterial puncture are:

  • Bleeding
  • Thrombosis (formation of a blood clot)
  • Infections
  • Development of aneurysms or arteriovenous fistulas

Accidental intra-arterial injection of medication can lead to necrosis and, in the case of barbiturates , possibly to the loss of an arm. The arterial access is therefore clearly marked to avoid accidental injections.

swell

See also