4178例患者进行了5142次动脉置管。动脉置管最常见的部位是桡动脉（N=3,395 [66.0％]）和股动脉（N=1,528 [29.7％]），其中11例发生并发症：8例血管相关和3例感染（总发生率0.2％；即2/1000；95％CI，1-4），均为股动脉置管的年龄小于5岁的儿童（0.7％；即7/1000；95％CI：4-13）。大部分股动脉置管为心脏手术（91％）。婴儿和新生儿的动脉置管并发症发生率最高（分别为16/1000和11/1000；95％CI，分别为7-34和3-39）。
翻译：易菁 编辑：佟睿 审校：曹莹
Major Short-term Complications of Arterial Cannulation for Monitoring in Children.
BACKGROUND: Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of major short-term complications associated with arterial cannulation for perioperative monitoring in children, and (2) describe the rates of major complications by anatomical site and age category of the patient.
METHODS: The authors examined a retrospective cohort of pediatric patients (age less than 18 yr) undergoing surgical procedures at a single academic medical center from January 1, 2006 to August 15, 2016. Institutional databases containing anesthetic care, arterial cannulation, and postoperative complications information were queried to identify vascular, neurologic, and infectious short term complications within 30 days of arterial cannulation.
RESULTS: There were 5,142 arterial cannulations performed in 4,178 patients. The most common sites for arterial cannulation were the radial (N = 3,395 [66.0%]) and femoral arteries (N = 1,528 [29.7%]). There were 11 major complications: 8 vascular and 3 infections (overall incidence, 0.2%; rate, 2 per 1,000 lines; 95% CI, 1 to 4) and all of these complications were associated with femoral arterial lines in children younger than 5 yr old (0.7%; rate, 7 per 1,000 lines; 95% CI, 4 to 13). The majority of femoral lines were placed for cardiac procedures (91%). Infants and neonates had the greatest complication rates (16 and 11 per 1,000 lines, respectively; 95% CI, 7 to 34 and 3 to 39, respectively).
CONCLUSIONS: The overall major complication rate of arterial cannulation for monitoring purposes in children is low (0.2%). All complications occurred in femoral arterial lines in children younger than 5 yr of age, with the greatest complication rates in infants and neonates. There were no complications in distal arterial cannulation sites, including more than 3,000 radial cannulations.
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