1. Radial-to-femoral pressure gradient quantification in cardiac surgery
- Author
-
Jean-Sébastien Lebon, André Y. Denault, Marco Julien, Alain Deschamps, Philippe Pérusse, Nicolas Rousseau-Saine, Yoan Lamarche, Georges Desjardins, Sylvie Levesque, Marie-Ève Chamberland, Loay Kontar, Athanase Courbe, Maria Rosal Martins, Christian Ayoub, Antoine Rochon, Jennifer Cogan, Meggie Raymond, Pierre Couture, Vincent Bouchard-Dechêne, and William Beaubien-Souligny more...
- Subjects
medicine.medical_specialty ,Mean arterial pressure ,business.industry ,Ultrasound ,Arterial catheter ,Cardiac surgery ,Blood pressure ,Internal medicine ,medicine.artery ,Vasoactive ,medicine ,Cardiology ,Radial artery ,business ,Pressure gradient - Abstract
A radial-to-femoral pressure gradient (RFPG) can occur in roughly one-third of cardiac surgical patients. Such a gradient has been associated with smaller stature and potentially smaller radial artery diameter. We hypothesized that preoperative radial artery diameter could be a predictor of RFPG. We also investigated the clinical impact of using a femoral versus a radial arterial catheter in terms of vasoactive support.Using ultrasound, we measured the bilateral radial artery diameters of 160 cardiac surgical patients. All arterial pressure values were continuously recorded. Significant RFPG was defined as ≥25 mm Hg in systolic and/or ≥10 mm Hg in mean arterial pressure. One hundred and forty-nine additional patients were used to validate the impact of our observations.Using 78,013 pressure datapoints in 129 patients, 34.8% of patients had an RFPG with a mean duration of 54 ± 48 minutes. Patients with a radial artery diameter1.8 mm were more likely to have an RFPG (n = 14 [48.3%] vs 12 [22.2%];A significant RFPG occurs in one-third of cardiac surgical patients and in 48% of those with a radial artery diameter1.8 mm. The use of a single radial arterial catheter instead of dual radial and femoral catheters was associated with greater vasopressor requirements in the operating room and in the intensive care unit. We do not recommend the use of a single radial artery catheter in cardiac surgery. more...
- Published
- 2021
- Full Text
- View/download PDF