LETTERS TO THE EDITOR: Letters & Announcements
To the Editor:
Radial arterial catheter placement is perhaps the most frequently performed invasive hemodynamic monitoring procedure. Although anesthesiologists perform a large number of this procedure with minimal complications, there are numerous reports of ischemia, thrombosis and infection. The purpose of this letter is to share a photograph demonstrating the potential consequences of infection (Fig. 1).
A 60-year-old hemodynamically unstable woman came to our operating room for an exploratory laparotomy. A 20G radial arterial catheter was placed for hemodynamic monitoring and blood sampling. The standard practice at our institution is to use strict aseptic technique including skin preparation with povidone iodine and sterile draping. At the end of the procedure she was transferred to the intensive care unit.
Seventy-two hours later the arterial cannulation site was noted to be inflamed and staphylococcus aureus cellulitis was diagnosed. The patient returned to the operating room for surgical debridement of the infected radial artery area. Aggressive antibiotic therapy, additional debridement, and skin grafting were required. This case should remind us that although radial artery cannulation is commonly performed, serious complications could occur.
Rafael Ortega, MD
Sundara K Rengasamy, MD
Keith P. Lewis, MD