The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Chuck Ramirez1

Background: Literature search for definitive dwell time and site care of radial arterial catheters (AL) is unclear. Patients requiring extended time in the intensive care may receive multiple AL.

Bench line data collected for three months of 2006. AL's were inserted with sterile technique and reinsertion was done on day 4. During the bench collection period 32 AL had a dwell time of 4 days. Site was evaluated for Swelling. Redness, Drainage, Bleeding and Tenderness. In January of 2007 reinsertion extended to 7 days. Dressing change and pressure tubing remained constant with a 4 day change. Pressure tubing changed down to the catheter hub and sterile dressing applied. During the nine month period 26 AL were reinserted at seven days. Forth quarter 2007 the trial was modified with the addition of a 6 inch extension and a 2 way stopcock. The transparent dressing covered the catheter and part of the extension tubing for 7 days. Pressure tubing continued to be changed down to the stopcock Q4 days. Data was collected for a 6 month period. 35 AL with the catheter and dressing intact for 7 days were observed during this period.

Observational changes in site appearance from 4 day reinsertion to 7 day reinsertion resulted in one AL or 3% change. Bench data compared 7 day reinsertion and dressing change resulted in two AL difference or 5%. Two of the lines with observational changes were cultured and results were negative. Of the 61 AL with dwell time of 7 days, 28 AL went 8 days or greater. One AL had dwell duration of 20 days without any observational changes indicating possible infection.

Arterial line insertion sites were observed for 18 months. No significant changes in site appearance were noted between reinserting AL every 4 days or every 7 days. There are also no observational benefits to changing the dressing less than 7 days if dressing remained intact.