Radial artery cannulation and reversible skin pallor after saline flushing. What do you do?

Radial artery cannulation and reversible skin pallor after saline flushing. What do you do?

Authors

Keywords:

Radial artery, cannulation, Vascular access, complications, spasm, skin pallor

Abstract

Radial artery cannulation is widely used in intensive care units. However, it is not free from risks. We cannulated the left radial artery in a 75-year-old man and observed this phenomenon but found poor information from literature searches. We propose that the pallor around the insertion site after flushing the line with saline may be due to the cold and high-pressure injection, causing localized superficial vasospasm. Luckily, skin pallor resolved once the arterial lavage was stopped. This phenomenon may be less observed by practitioners leading to underestimating the possibility of related complications. 

Author Biographies

Carmen Fierro, D'Annunzio University of Chieti-Pescara

Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.

Medical doctor, "Anesthesia, pain and intensive care" resident

Luigi Vetrugno

 Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.

Associate Professor

 

Salvatore Maurizio Maggiore, D'Annunzio University of Chieti-Pescara

Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.

Full Professor

 

References

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Vetrugno L, Costa MG, Spagnesi L et al. Uncalibrated arterial pulse cardiac output measurements in patients with moderately abnormal left ventricular function. J Cardiothorac Vasc Anesth. 2011 Feb;25(1):53-8. doi: 10.1053/j.jvca.2010.07.001. Epub 2010 Sep 20.

Costa MG, Chiarandini P, Vetrugno L, et al. Uncalibrated continuous cardiac output measurement in liver transplant patients: LiDCOrapid™ system versus pulmonary artery catheter. J Cardiothorac Vasc Anesth. 2014 Jun;28(3):540-6. doi: 10.1053/j.jvca.2013.12.027.

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Published

24-07-2023

Issue

Section

Case Reports: General Surgery and Miscellanea

How to Cite

1.
Fierro C, Vetrugno L, Maggiore SM. Radial artery cannulation and reversible skin pallor after saline flushing. What do you do? . Acta Biomed [Internet]. 2023 Jul. 24 [cited 2024 Jul. 18];94(S1):e2023142. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/14199