Arterial line
Arterial Line
An arterial line (also known as an art line or A-line) is a thin catheter inserted into an artery. It is most commonly used in intensive care medicine and anesthesia to monitor the blood pressure of critically ill patients in real-time and to obtain samples for arterial blood gas analysis.
Purpose
The primary purpose of an arterial line is to provide continuous blood pressure monitoring. This is crucial in patients who are hemodynamically unstable or undergoing major surgery. The arterial line allows for the detection of rapid changes in blood pressure, which can be critical for timely medical intervention. Additionally, arterial lines facilitate frequent blood sampling without repeated needle sticks, which is particularly beneficial for patients requiring regular arterial blood gas analysis.
Insertion Technique
The insertion of an arterial line is typically performed using the Seldinger technique, which involves the use of a guidewire to place the catheter into the artery. Common sites for arterial line insertion include the radial artery, femoral artery, and brachial artery. The radial artery is the most frequently used site due to its superficial location and ease of access.
Complications
While arterial lines are invaluable in critical care, they are not without risks. Potential complications include infection, thrombosis, hematoma, and ischemia of the limb distal to the insertion site. Careful monitoring and maintenance of the arterial line are essential to minimize these risks.
Maintenance
Proper maintenance of an arterial line involves regular flushing with saline to prevent clot formation, ensuring the line is secure to prevent accidental dislodgement, and monitoring the insertion site for signs of infection or other complications. The use of a pressure bag is necessary to maintain the patency of the line and to ensure accurate pressure readings.
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Contributors: Prab R. Tumpati, MD