Le cathétérisme prolongé de l'artère radiale. Evaluation prospective du risque thrombogène et infectieux

Abstract

The rates of thrombosis and infection were studied in 102 patients who underwent 107 radial artery cannulations. A Leader cath, ORX cannula (Vygon) was placed using Seldinger's method. It was continuously perfused with an heparinized 5 % dextrose solution via an Intraflo fixed upon an arterial catheter. The cannulac were used for arterial pressure monitoring and measuring arterial blood gases. Before removing the catheter, a forearm arteriography was realized with 20 ml Hexabrix®. Bacterial examination and culture were carried out on the cannula tips. 70 men and 32 women (mean age : 50±17 years) were studied. Mean duration of cannulation was 9±7 days (range : 1–34 days). Complete or partial radial artery thrombosis occurred in 85 %. Complete thrombosis occurred more frequently in women (84 %) than in men (54 %) (p <0.05). There was no correlation between thrombosis and duration of cannulation (9.9± days for thrombosis and 7.9±4.3 days without thrombosis). Bacterial cultures of cannula tips were positive in 24 % of cannulations. Pathogenic bacilli grew in only 9 %. Infected cannulas were in situ for 9.9±7 days against 8.9±6.7 days for the non-infected cannulas ( ns). There was no correlation between infection and radial artery thrombosis. The use of another material (silicone, Teflon) must be studied in order to decrease the occurrence of thrombosis.