Related Neurological Complications Research Articles

The emerging mechanism behind viral infections and extracellular vesicles hypotheses leading to neuroinflammation and Alzheimer's disease pathology.

Despite decades of repeated and intense research, the etiology of sudden Alzheimer's disease (AD) symptoms is still unclear. AD progressive pathology mainly involves neuron damage, depositions of amyloid-beta (Aβ), and hyperphosphorylated tau protein. All these defects are manifested by exaggerated cytokine storm and neuroinflammation leading to irreversible brain damage in the long term. Despite the numerous risks and drawbacks associated with AD, it is believed that there is a hidden unknown causative and predisposing factors for AD. Extracellular vesicles (EVs) are small vesicles released by cells as a type of intercellular communication. Several pieces of evidence support the inclusion of viral components within EVs facilitating their penetration into the blood-brain barrier leading to neuroinflammation. In light of the SARS-CoV-19 pandemic and its related neurological complications, it is mandatory to highlight the possibility and viability of viral infections such as varicella-zoster virus (VZV) and herpes simplex virus (HSV) on the onset of AD. Herein, the author is investigating the potential role of VZV and HSV along with highlighting the suggested route of pathogenesis entry resulting in AD manifestations. Additionally, this review aims to summarize the role of EVs in mediating the central nervous system viral infections leading to AD.

Magnetic Resonance Imaging findings in pregnancy related neurological complications.

To describe the various neurological complications that occur in pregnancy and puerperium using magnetic resonance imaging as the diagnostic tool. The prospective study was conducted at the Radiology Department of Lady Reading Hospital, Peshawar, Pakistan, from June 2018 to June 2019, and comprised pregnant and puerperium patients presenting with neurological symptoms who were referred for magnetic resonance imaging. Clinical records of the patients were reviewed for risk factors and neurological symptomatology. Imaging was done using a 1.5Tesla machine. Departmental routine imaging protocols for magnetic resonance imaging brain and magnetic resonance venography were used. Data was analysed using SPSS 23. There were 60 pregnant women with a mean age of 25.85±5.1 years (range: 17-40 years). Magnetic resonance imaging showed posterior reversible encephalopathy syndrome in 20(33.3%) patients and haemorrhagic infarct in 18(30%), while 9(15%) were found to be normal. Magnetic resonance venography exhibited dural sinus thrombosis in 19(31.7%) patients. Magnetic resonance imaging was found to play a vital role in early diagnosis of pregnancy-related neurological complications.

Effects of Varying Glucose Concentrations on ACE2's Hypothalamic Expression and Its Potential Relation to COVID-19-Associated Neurological Dysfunction.

The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted millions of lives, despite several vaccine interventions and strict precautionary measures. The main causative organism of this disease is the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) which infects the host via two key players: the angiotensin-converting enzyme 2 (ACE2) and the transmembrane protease, serine 2 (TMPRSS2). Some reports revealed that patients with glycemic dysregulation could have increased susceptibility to developing COVID-19 and its related neurological complications. However, no previous studies have looked at the involvement of these key molecules within the hypothalamus, which is the central regulator of glucose in the brain. By exposing embryonic mouse hypothalamic neurons to varying glucose concentrations, we aimed to investigate the expression of ACE2 and TMPRSS2 using quantitative real time polymerase chain reaction and western blotting. A significant and time-dependent increase and decrease was observed on the viability of hypothalamic neurons with increasing and decreasing glucose concentrations, respectively (p < 0.01 and p < 0.001, respectively). Under the same increasing and decreasing glucose conditions, the expression of hypothalamic ACE2 also revealed a significant and time-dependent increase (p < 0.01). These findings suggest that SARS-CoV-2 invades the hypothalamic circuitry. In addition, it highlights the importance of strict glycemic control for COVID-19 in diabetic patients.

Chronically administered Agave americana var. marginata extract ameliorates diabetes mellitus, associated behavioral comorbidities and biochemical parameters in alloxan-induced diabetic rats

IntroductionDiabetes mellitus causes hyperglycemia and associated complications to the brain. In current study, the traditionally reported remedial claims of Agave americana var. marginata has been scientifically investigated in diabetic rats. MethodologyThe methanolic extract of leaves of Agave americana var. marginata (Aa.Cr) was characterized for total phenols, flavonoids, and antioxidant potential through in-vitro testing. The rats chronically pre-treated with Aa.Cr (400 and 600 mg/kg) for 45 days were challenged with alloxan-induced hyperglycemia. The dose-dependent effects of Aa.Cr on blood glucose levels and body weights were compared with diabetic rats using glibenclamide (0.6 mg/kg) as a standard. The animals were tested for diabetes-associated neurological comorbidities through behavioral and biochemical evaluation. ResultsThe phenols and flavonoids enriched Aa.Cr caused a significant dose-dependent hypoglycemic effect. Aa.Cr showed protection from comorbid anxiety, depression and cognitive impairment as compared to diabetic rats. The alanine aminotransferase, total cholesterol, triglycerides and low-density lipoprotein were prominently reduced, and high-density lipoprotein was increased in rats treated with Aa.Cr. Moreover, the oxidative stress in isolated brains was reduced by Aa.Cr. ConclusionThese findings suggest that Aa.Cr is enriched with antioxidant and anti-inflammatory phytoconstituents valuable for diabetes and related neurological complications.

Eotaxin-1 (CCL11) in neuroinflammatory disorders and possible role in COVID-19 neurologic complications.

The related neurologic complications of SARS-CoV-2 infection in COVID-19 patients and survivors comprise symptoms including depression, anxiety, muscle pain, dizziness, headaches, fatigue, and anosmia/hyposmia that may continue for months. Recent studies have been demonstrated that chemokines have brain-specific attraction and effects such as chemotaxis, cell adhesion, modulation of neuroendocrine functions, and neuroinflammation. CCL11 is a member of the eotaxin family that is chemotactic agents for eosinophils and participate in innate immunity. Eotaxins may exert physiological and pathological functions in the central nerve system, and CCL11 may induce neuronal cytotoxicity effects by inducing the production of reactive oxygen species (ROS) in microglia cells. Plasma levels of CCL11 elevated in neuroinflammation and neurodegenerative disorders. COVID-19 patients display elevations in CCL11 levels. As CCL11 plays roles in physiosomatic and neuroinflammation, analyzing the level of this chemokine in COVID-19 patients during hospitalization and to predicting post-COVID-19-related neurologic complications may be worthwhile. Moreover, using chemokine modulators may be helpful in lessening the neurologic complications in such patients.

Multi-disciplinary rehabilitation for management of diabetes mellitus related neurological and musculoskeletal complications.

Diabetes Mellitus (DM) is one of the most common metabolic disorders in the world. It can result in several neurological and musculoskeletal (MSK) conditions. These conditions adversely affect the mobility, community functioning and quality of life for the patient with DM. Rehabilitation Medicine Physicians (Physiatrists) can offer both diagnostic and therapeutic interventions for the accurate diagnosis and optimal management of neurological and MSK conditions associated with DM. These include diagnostic tests such as Nerve Conduction Studies and Electromyography, therapeutic interventions in form of pharmacological management of symptoms, prescription of appropriate physical therapy, occupational therapeutic exercise, injections, as well as psychosocial and cognitive interventions. A physiatrist can provide expert advice on musculoskeletal disorders in patients with DM, as they are formally trained in the evaluation, diagnosis, and management of MSK conditions. A multidisciplinary team for DM should include a physiatrist as one of the key members. This can help effectively address neurological and MSK disorders related to DM.

Association of Tourette Syndrome and Chronic Tic Disorder With Cervical Spine Disorders and Related Neurological Complications

Severe forms of Tourette syndrome or chronic tic disorder (TS/CTD) may involve repeated head jerking. Isolated case reports have described a spectrum of severe neck disorders in individuals with TS/CTD. However, the nature and prevalence of cervical spine disorders in TS/CTD are unknown. To establish if TS/CTD are associated with an increased risk of cervical spine disorders and related neurological complications compared with individuals from the general population. All individuals born from 1973 to 2013 and living in Sweden between 1997 and 2013 were identified. Individuals with a record of TS/CTD diagnosed in specialist settings were matched on age, sex, and county of birth with 10 unexposed individuals randomly selected from the general population. Cox proportional hazards regression models were used to estimate the risk of vascular and nonvascular cervical spine disorders among exposed individuals, compared with unexposed individuals. Models were adjusted for other known causes of cervical spine injury. Data were analyzed from March 19 to May 16, 2021. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses of TS/CTD in the Swedish National Patient Register. Records of cervical vascular disorders (ie, aneurysm, cerebral infarction, transitory cerebral ischemia) and cervical nonvascular disorders (ie, spondylosis, cervical disc disorders, fractures of the cervical spine, cervicalgia) and cervical surgeries. Covariates included rheumatic disorders, traffic injuries, fall- or sport-related injuries, and attention-deficit/hyperactivity disorder comorbidity. A total of 6791 individuals with TS/CTD were identified (5238 [77.1%] were male; median [interquartile] age at first diagnosis, 15.6 [11.4-23.7] years) and matched to 67 910 unexposed individuals. Exposed individuals had a 39% increased risk of any cervical spine disorder (adjusted hazard ratio, 1.39; 95% CI, 1.22-1.59). Adjusted hazard ratios for cervical vascular and nonvascular disorders were 1.57 (95% CI, 1.16-2.13) and 1.38 (95% CI, 1.19-1.60), respectively. Risks were similar among men and women. Individuals with severe TS/CTD are at increased risk of cervical spine disorders. These outcomes are relatively rare but may lead to persistent disability in some individuals and thus require close monitoring to facilitate early interventions.

The spectrum of Epstein-Barr virus infections of the central nervous system after organ transplantation

BackgroundEpstein-Barr virus (EBV)-related neurologic complications have a diverse presentation in transplant recipients, creating diagnostic and therapeutic challenges for clinicians. In this case series, we report unique manifestations of EBV related neurologic complications following solid organ transplant and highlight pitfalls in management.Case presentationsA retrospective search of the electronic medical record of all patients from January 2015 to December 2020 who underwent solid organ transplantation and had central nervous system complications as determined by ICD-10 codes were included. Three patients with unique manifestation of EBV-related neurologic complications after liver transplantation were identified. The first was a 52-year-old man with a live-donor liver transplant 11 years prior for Budd-Chiari syndrome presented with several weeks of headache and several lesions on brain MRI; he was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder. The second patient was a 63-year-old man with a deceased-donor liver transplant 16 years prior for alpha-1-antitrypsin deficiency and was found to have a stroke; he was diagnosed with EBV encephalitis. The final patient was a 75-year-old woman with a deceased-donor liver transplant six years prior for primary biliary cirrhosis who presented with four months of gait instability; she was diagnosed with EBV myelitis. A review of the literature was performed to supplement description of the different diseases.ConclusionsEBV-related central nervous infection in post-transplant patients can manifest in a variety of neurologic syndromes, which can be challenging to diagnose. Careful correlation of clinical, pathologic, and radiologic findings and a high index of suspicion are crucial in identification and appropriate management.

Short Communication on Recent Published Articles in Journal of Microbial and Biochemical Technology

Very recently severe acute respiratory syndrome CoV 2 (SARS-CoV-2) that caused coronavirus disease 2019 (COVID-19) has been detected in the neural and capillary endothelial cells of the frontal lobe in postmortem tissue of a patient. Besides, the association of neurological symptoms such as confusion, impaired consciousness, headache, meningitis, acute stroke, encephalitis, hemorrhage, seizure and early symptoms of Guillian-Barre like symptoms in the SARS-CoV-2 patients has raised great concern about the potential impact of the neuroinvasion of SARS-CoV-2. However, the exact pathomechanism of the SARS-CoV-2 infection is not completely understood. Lack of study on the SARS-CoV-2 mediated infection of the central nervous system (CNS) makes it difficult to evaluate how SARS-CoV-2 invades the nervous system and causes neuronal damage and cognitive impairment. Here, we discuss the neurological manifestations of COVID 19, the pathomechanism, and possible route of invasion of SARS-CoV-2 in the CNS. We also emphasize the importance of better understandings of neuroinvasion of SARS-CoV-2 to develop better therapeutic approaches to treat COVID 19 related neurological complications.

Short Communication on Recent Published Articles in Journal of Microbial and Biochemical Technology

Very recently severe acute respiratory syndrome CoV 2 (SARS-CoV-2) that caused coronavirus disease 2019 (COVID-19) has been detected in the neural and capillary endothelial cells of the frontal lobe in postmortem tissue of a patient. Besides, the association of neurological symptoms such as confusion, impaired consciousness, headache, meningitis, acute stroke, encephalitis, hemorrhage, seizure and early symptoms of Guillian-Barre like symptoms in the SARS-CoV-2 patients has raised great concern about the potential impact of the neuroinvasion of SARS-CoV-2. However, the exact pathomechanism of the SARS-CoV-2 infection is not completely understood. Lack of study on the SARS-CoV-2 mediated infection of the central nervous system (CNS) makes it difficult to evaluate how SARS-CoV-2 invades the nervous system and causes neuronal damage and cognitive impairment. Here, we discuss the neurological manifestations of COVID 19, the pathomechanism, and possible route of invasion of SARS-CoV-2 in the CNS. We also emphasize the importance of better understandings of neuroinvasion of SARS-CoV-2 to develop better therapeutic approaches to treat COVID 19 related neurological complications.

COVID 19 and The Brain

Very recently severe acute respiratory syndrome CoV 2 (SARS-CoV-2) that caused coronavirus disease 2019 (COVID-19) has been detected in the neural and capillary endothelial cells of the frontal lobe in postmortem tissue of a patient. Besides, the association of neurological symptoms such as confusion, impaired consciousness, headache, meningitis, acute stroke, encephalitis, hemorrhage, seizure and early symptoms of Guillian-Barre like symptoms in the SARS-CoV-2 patients has raised great concern about the potential impact of the neuroinvasion of SARS-CoV-2. However, the exact pathomechanism of the SARS-CoV-2 infection is not completely understood. Lack of study on the SARS-CoV-2 mediated infection of the central nervous system (CNS) makes it difficult to evaluate how SARS-CoV-2 invades the nervous system and causes neuronal damage and cognitive impairment. Here, we discuss the neurological manifestations of COVID 19, the pathomechanism, and possible route of invasion of SARS-CoV-2 in the CNS. We also emphasize the importance of better understandings of neuroinvasion of SARS-CoV-2 to develop better therapeutic approaches to treat COVID 19 related neurological complications.

Spectrum of Neurologic Complications in COVID-19: An Evidence-Based Review

AbstractThe world is facing an unprecedented crisis due to the pandemic of current coronavirus disease 2019 (COVID-19). Coronavirus (CoVs) infections not only are always involving the respiratory tract but also possess significant neuroinvasive potential. The literature regarding neuropathogenic potential of human CoVs is sparse. Thus, the number of COVID-19–related neurologic complications is likely to be underestimated. Awareness regarding the possible spectrum of neurologic complications is essential for therapeutic decision-making and individualized treatment and thereby limiting the COVID-19–related morbidity and mortality. The aim of this review is to address the neurologic manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Analgetic effect of ozone therapy: myths of reality?

Introduction: Administration of an oxygen-ozone mixture is one of the innovative techniques used in single-drug or complex therapeutic schemes for treatment of many degenerative-dystrophic pathologies of the musculoskeletal system and related neurological complications. Aim: The aim was to determine the mechanisms of physiological action of the oxygen-ozone mixture in order to substantiate its efficacy for treatment of chronic pain syndrome with underlying degenerative-dystrophic pathologies of the musculoskeletal system. Material and methods: The article covers biochemical and pathomorphological studies that explain the mechanism of the pain syndrome and the potential effect of the ozone therapy. Results and discussion: The treatment schemes and benefits of different routes of ozone administration (intramuscularly, intravenously, intradiscally and intraarticularly) were analyzed. Diverse research data demonstrated influence on the causes of chronic pain, pathophysiological phases, and possible complications. The prospects of further studies for development of the most effective techniques for treatment of various pain syndromes were assessed. Conclusions: Ozone therapy is one of the alternative rehabilitation methods with a substantial pain relieving effect. As of today, the possibility of using the oxygen-ozone mixture for treatment of chronic back pain related to intervertebral disk hernia and fibromyalgia has been substantially confirmed.

Effects of Moringa oleifera on Glycaemia and Insulin Levels: A Review of Animal and Human Studies.

Diabetes and related neurological complications are serious worldwide public health problems. The increasing number of affected individuals make it necessary to implement novel nutritional and therapeutic interventions. The tree Moringa oleifera (MO) has been used as a food source and for traditional medicine purposes due to possible antihyperglycemic, antioxidant, anti-inflammatory, and lipid regulating properties. These properties may be explained by the presence of numerous phytochemicals in the leaves, fruits, roots and, oil of the tree. The evidence for acute antihyperglycemic effects of MO extract on diabetic animal models seems to be robust, but more chronic and long-term studies are needed. In contrast, the hypoglycemic effects of MO on humans are not as clear. The scarce number of human studies, together with a diverse range of methodologies and MO doses, may explain this. In addition, evidence regarding changes in insulin levels due to MO intervention is ambiguous, both in animal and human studies. Therefore, more structured studies are needed to clarify if MO has an effect on insulin levels or activity.

Sepsis related neurological complications

The central nervous system (CNS) complications and peripheral nervous system (PNS) complications are common complications of sepsis.CNS complications include sepsis associated encephalopathy (SAE), septic-metastatic encephalitis (SME), and septic-embolic encephalitis (SEE). Of them, the SAE is the most common complication of CNS complications.PNS complications include critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). CIP and CIM could lead to muscle weakness and dependence on mechanical ventilation of patients with sepsis.Sepsis related neurological complications are closely related to the mortality and prognosis of patients, so early recognition and timely intervention are important. Key words: Sepsis; Neurological complication; Sepsis associated encephalopathy; Sepsis-induced brain dysfunction; Carritical illness polyneuropathy; Critical illness myopathy,

Ossification of the Posterior Longitudinal Ligament in Cervical Spine: Prevalence, Management, and Prognosis.

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine and related neurological complications are not uncommon in East Asian countries. The estimated prevalence of cervical OPLL-related hospitalization is 7.7 per 100,000 person-years in Taiwan, and higher incidence rates have been observed in elderly and male patients. Although cervical OPLL is frequently insidious, it can eventually cause myelopathy and predispose patients to spinal cord injury (SCI). There are multiple options for managing cervical OPLL, ranging from observation to many kinds of surgical procedures, including posterior laminoplasty, laminectomy with or without fusion, anterior corpectomy with or without instrumentation, and circumferential decompression and fusion. None of these surgical approaches is free of complications. However, to date, there is still a lack of consensus regarding the choice of the surgical approach and the timing of surgical intervention. Cervical SCI and related neurological disabilities are more likely to occur in OPLL patients, who should therefore be cautioned regarding the possibility of a subsequent SCI if treated without surgery. This article aimed to review the prevalence, management strategies, and prognosis of cervical OPLL.

Percutaneous pinning versus volar locking plate fixation for dorsally displaced distal radius fractures- reoperation rates over an eight year period

PurposeTo compare reoperation rates between closed reduction with percutaneous pinning (CRPP) and internal fixation with a volar locking plate (VLP) for the treatment of distal radius fractures. MethodsA retrospective review of all patients with dorsally displaced distal radius fractures presenting to a hospital over an eight-year period. Results1364 procedures were reviewed after applying the exclusion criteria; 663 underwent CRPP and 701 underwent VLP. The results showed that CRPP had higher rates of revision surgery due to fixation failure than VLP (p = 0.003), however there was no statistical significance in overall reoperation rates when all complications were considered (p = 0.060). This was due to higher rates of tendon related problems (p = 0.003), neurological complications (p = 0.005) and hardware removal (p = 0.01) in the VLP group. ConclusionOverall reoperation rates were similar between both techniques however there were differences in complication profile and nature of revision surgery. This information is useful when discussing treatment options with patients to help guide selection of the best procedure for that individual.

119 CORRECTION OF EXTREME HYPERNATREMIA IN ACUTE KIDNEY INJURY WITH CONTINUOUS RENAL REPLACEMENT THERAPY: A CASE REPORT

Category: RRT Technique Characteristics Presenter: Dr SU HOOI TEO Keywords: Acute Kidney Injury, Hypernatremia Management of extreme hypernatremia in patients with acute kidney injury (AKI) with hemodialysis poses a therapeutic challenge with risk of inadvertent over-rapid hypernatremia correction. An 84 year-old 49kg man with history of hypertension and cerebrovascular accident presented with a three-day history of reduced oral intake and cough. On examination, he was severely dehydrated and confused, with blood pressure of 115/67 mmHg and heart rate of 107/min. Initial laboratory investigations showed serum sodium of 173 mmol/L, serum creatinine of 291 umol/L and urea of 56.3 mmol/L. His baseline creatinine was 120 umol/L. He was diagnosed to have AKI secondary to severe dehydration and pneumonia, and started on intravenous hydration with estimated total water deficit of 4.7 L. He however did not respond and decision was made to initiate continuous venovenous hemodiafiltration (CVVHDF) with Qb (blood flow rate) of 150ml/min, Qd (dialysate flow rate) of 0.5L/hour, Qr (replacement flow rate) of 1L/hour. Customization of dialysate and replacement fluid by modifying sodium concentration was performed with addition of calculated amount of 3% Hypertonic Sodium Chloride solution. The mean achieved sodium correction was a reduction of 6 mmol/L every 24 hours from 168 mmol/L to 150 mmol/L over 72 hours, followed by 2 sessions of intermittent hemodialysis with sodium modeling with subsequent complete normalization of serum sodium level. Hypernatremia is an important risk factor for mortality in critically ill patient. Continuous renal replacement therapy (CRRT) may be useful in extreme hypernatremia to allow gradual, stepwise and controlled correction of hypernatremia with the aim of preventing cerebral oedema and related neurological complications. Current recommendation suggests that a daily maximal reduction in serum concentration of 8 to 10 mmol/L is considered safe especially in setting of chronic hypernatremia.

High-Content Screening in hPSC-Neural Progenitors Identifies Drug Candidates that Inhibit Zika Virus Infection in Fetal-like Organoids and Adult Brain

Zika virus (ZIKV) infects fetal and adult human brain and is associated with serious neurological complications. To date, no therapeutic treatment is available to treat ZIKV-infected patients. We performed a high-content chemical screen using human pluripotent stem cell-derived cortical neural progenitor cells (hNPCs) and found that hippeastrine hydrobromide (HH) and amodiaquine dihydrochloride dihydrate (AQ) can inhibit ZIKV infection in hNPCs. Further validation showed that HH also rescues ZIKV-induced growth and differentiation defects in hNPCs and human fetal-like forebrain organoids. Finally, HH and AQ inhibit ZIKV infection in adult mouse brain invivo. Strikingly, HH suppresses viral propagation when administered to adult mice with active ZIKV infection, highlighting its therapeutic potential. Our approach highlights the power of stem cell-based screens and validation in human forebrain organoids and mouse models in identifying drug candidates for treating ZIKV infection and related neurological complications in fetal and adult patients.

Brachial Arterial Pressure Monitoring during Cardiac Surgery Rarely Causes Complications.

Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015. Complications within 6 months after surgery were identified by International Classification of Diseases, Ninth Revision diagnostic and procedural codes, Current Procedural Terminology procedure codes, and Society of Thoracic Surgeons variables. The authors reviewed electronic medical records to confirm that putative complications were related plausibly to brachial arterial catheterization. Complications were categorized as (1) vascular, (2) peripheral nerve injury, or (3) infection. The authors evaluated associations between brachial arterial complications and patient comorbidities and between complications and in-hospital mortality and duration of hospitalization. Among 21,597 qualifying patients, 777 had vascular or nerve injuries or local infections, but only 41 (incidence 0.19% [95% CI, 0.14 to 0.26%]) were potentially consequent to brachial arterial cannulation. Vascular complications occurred in 33 patients (0.15% [0.10 to 0.23%]). Definitely or possibly related infection occurred in 8 (0.04% [0.02 to 0.08%]) patients. There were no plausibly related neurologic complications. Peripheral arterial disease was associated with increased risk of complications. Brachial catheter complications were associated with prolonged hospitalization and in-hospital mortality. Brachial artery cannulation for hemodynamic monitoring during cardiac surgery rarely causes complications.