Arterial Catheterization and Infection: Toll-like Receptors in Defense against Microorganisms and Therapeutic Implications.
Radial artery catheterization has become a preferred route over femoral artery catheterization, in order to monitor the blood pressure of hemodynamically unstable patients or for repeated sampling of arterial blood gases. While the incidence of catheter-related infection is lower in the radial artery than the femoral artery, infection remains a major issue that requires attention. In this review of the literature, we discuss infectious complications of radial artery catheterization, with a focus on various risk factors and establishing the most common causative agents. We also critically review the role of the innate immune system involving Toll-like receptors (TLRs) in host-defense, with the goal of establishing a common pathway used by the innate immune system via TLRs to combat the pathogens that most commonly cause infection in radial artery catheterization. If this pathway can be therapeutically manipulated to preemptively attack pathogenic agents, immunomodulation may be an option in reducing the incidence of infection in this procedure.
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Zakary J
ZJ
Hambsch
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Mitchell J
MJ
Kerfeld
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Daniel R
DR
Kirkpatrick
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Dan M
DM
McEntire
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Mark D
MD
Reisbig
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Charles F
CF
Youngblood
Center for Clinical & Translational Science and Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Devendra K
DK
Agrawal
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization; D057785:Catheters; D048909:Diabetes Complications / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D007113:Immunity, Innate; D007239:Infections / Q000473:pathology* / Q000628:therapy*; D037181:Lectins, C-Type / Q000378:metabolism; D008024:Ligands; D009369:Neoplasms / Q000150:complications; D017534:Radial Artery / Q000473:pathology*; D012307:Risk Factors; D015398:Signal Transduction; D051193:Toll-Like Receptors / Q000378:metabolism*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D037181:Lectins, C-Type; D008024:Ligands; D051193:Toll-Like Receptors
Toll-like receptors; arterial catheterization; innate immunity; radial artery