SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Intra-arterial catheters (IAC) placement is common in the intensive care unit (ICU), with studies showing more than third of ICU admissions will have one placed. However, the benefit of IAC is questionable, with comparable reading from non-invasive, less costly blood pressure measurements, as well as risk of complications such as infections, limb ischemia, and pseudoaneurysm. With that, there is a call for studies to define their role and type of patient to best benefit from them. We conducted a retrospective cohort study to determine the correlation between IAC placement and days alive and vasopressor free in adults admitted to the ICU on vasopressors METHODS: We used the eICU Collaborative Research Database, a freely available multi-center database for critical care research, which consists more than two hundred thousand patient encounters admitted to 335 ICUs in the United States in 2014 and 2015. Patients were included if vasopressors were started within 10 hours prior to admission or within 24 hours of ICU admission. IAC placement was defined as a minimum of five invasive blood pressure readings on the day of admission. The primary outcome was days alive and free of vasopressors at day 7. Secondary outcomes were inpatient mortality, total duration of vasopressor therapy, and acute kidney injury defined as doubling of serum creatinine or need for renal replacement therapy. A nearest neighbor 1:1 propensity score (PS) matching was conducted to find the best control for each treated unit, with the PS (probability of receiving IAC) estimated from a logistic regression from the following matching variables: age, severity of illness, full therapy status, and type of hospital. Sensitivity analysis included trying various matching methods, matching cut-off criteria, PS modeling options on the matched cohort, and a logistic regression estimating the outcomes on the unmatched cohort. RESULTS: A total of 17,218 ICU admissions were included in the cohort, in which 9,442 (54.8%) had IAC. After matching, IAC was associated with similar hours alive and free of vasopressors (Median difference -1.35 hours, CI: -3.15, 0.08, p = NS), unchanged mortality (OR 0.95, CI: 0.89 – 1.01, p = NS), and similar time on vasopressors (1.08 days vs. 1.07 days, p = NS) but associated with increased risk of renal dysfunction (OR 1.36, CI 1.22 – 1.51, p < 0.01). The results from sensitivity analysis were consistent with the primary analysis. CONCLUSIONS: IAC use in patients admitted to the ICU on vasopressors is not associated with a difference in time alive and free of vasopressors or increased risk of death but is associated with new renal dysfunction. CLINICAL IMPLICATIONS: The routine use of IAC in patients with shock should be studied prospectively DISCLOSURES: No relevant relationships by Sura Alqaisi, source=Web Response No relevant relationships by Andrew Barros, source=Web Response No relevant relationships by Hyunjoon Lee, source=Web Response no disclosure on file for Susana Margare; No relevant relationships by Susan McLean, source=Web Response No relevant relationships by Hieu Nguyen, source=Web Response No relevant relationships by Priscilla Rivera, source=Web Response No relevant relationships by Saira Samani, source=Web Response