有创动脉监测的并发症（Complications of invasive arterial monitoring）.docVIP

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有创动脉监测的并发症（Complications of invasive arterial monitoring）.doc

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有创动脉监测的并发症（Complications of invasive arterial monitoring）

有创动脉监测的并发症（Complications of invasive arterial monitoring） (1) thromboembolism; Thromboembolism caused by 1. radial artery indwelling catheter is the most serious complication. The radial artery is the most common puncture site for arterial cannulation. In most cases, thromboembolism after radial artery catheterization occurs in low blood volume, slow flow, or the use of alpha adrenergic agonists. (1) there is no definite test for lateral collateral circulation to predict whether ischemia occurs in the distal limb. Allen tests are widely used. The Allen test did not specify how long the ulnar artery would be released after the hand was removed, and the color of the hand should be restored. Bedford thinks 15 seconds is too long, 5 seconds is ideal. For the unconscious or unable to cooperate the patient is difficult to test the Allen, but can choose other evaluation methods of collateral circulation, such as the use of finger radial artery to temporarily closed, and then use the reverse flow ultrasound in hand. The pulse oximetry apparatus can qualitatively assess the pulsatile blood flow of the thumb when blocking the ulnar or radial arteries. Another method is whether in the artery distal arterial pulsation can palpable retrograde palmar arch finger pressure blocking radial artery; if the arterial pulse impalpable and retrograde, is recommended by other artery or hand side. If the bilateral collateral circulation is satisfactory, then the non dominant side of the hand radial artery should be selected. (2) thrombosis, the incidence of thrombosis caused by radial artery catheterization is related to the time of indwelling catheter and the percentage of vessel occupying the lumen. Therefore, the female artery is generally smaller than the male, and the incidence of arterial occlusion is higher after the arterial cannulation. Weiss and Gattiker believe that the perimeter of the 20G catheter is the lower limit of the 15cm, and that the finer wrists and the radial arteries