title: Lesser incidence of accidental catheter removal with femoral versus radial arterial access.
abstract: BACKGROUND
  Arterial catheterization is a frequent procedure in Intensive Care Units (ICUs). Accidental catheter removal (ACR) can cause severe and potentially life-threatening complications such as severe bleeding and vascular damage. Few data are available on accidental arterial catheter removal, and no studies have been found comparing the incidence of ACR between different arterial catheter sites.
  
  
  OBJECTIVE
  To compare the incidence of ACR in femoral and radial arterial catheters.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A polyvalent ICU.
  
  
  METHODS
  All consecutive patients subjected to femoral or radial arterial catheterization.
  
  
  METHODS
  The incidence of ACR per 100 catheter-days between groups was compared using Poisson regression. We considered ACR as the presence of unintended removal produced by the patient or healthcare personnel.
  
  
  RESULTS
  A total of 2419 radial and 1085 femoral arterial catheters were inserted and remained in situ during 14,742 and 6497 days, respectively. We detected 45 cases of ACR with the femoral access and 162 cases with the radial access. The ACR rate was lower with the femoral access (4.1% vs 6.7% in the case of the radial access; p=0.003). Poisson regression analysis confirmed a lower incidence of ACR with the femoral versus the radial access (0.69 vs 1.10 ACR events per 100 catheter-days; OR 0.6, p=0.006, CI95% 0.01-0.83).
  
  
  CONCLUSIONS
  The incidence of ACR was found to be lower with the femoral than with the radial arterial catheters. In order to improve patient safety, it could be interesting to exhaustively monitor the incidence of ACR and adopt preventive measures, since ACR can give rise to serious complications.
authors.affiliation: Department of Intensive Care, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com
authors.forename: L
authors.initials: L
authors.lastname: Lorente
authors.forename: M T
authors.initials: MT
authors.lastname: Brouard
authors.forename: I
authors.initials: I
authors.lastname: Roca
authors.forename: A
authors.initials: A
authors.lastname: Jiménez
authors.forename: E
authors.initials: E
authors.lastname: Pastor
authors.forename: N
authors.initials: N
authors.lastname: Lafuente
authors.forename: M L
authors.initials: ML
authors.lastname: Mora
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D017534:Radial Artery; D012189:Retrospective Studies