Assessment of peripheral arterial catheters as a source of sepsis in the critically ill: a narrative review.
Background: Bronchiolitis is a common cause of respiratory failure in children. Respiratory failure, in the PICU, is often managed with the utilization of arterial cannulas and frequent arterial blood gas sampling. Despite the common use of arterial blood sampling, it is unclear if these tests improve outcomes. Objective: To evaluate the frequency of blood draws for blood gas sampling and the duration of mechanical ventilation in children with respiratory failure with bronchiolitis in whom arterial cannel as were placed after initiation of mechanical ventilation.Setting: Children were recruited from a tertiary care children’s hospital. Design: Retrospective cohort study. Setting: TPICU at a tertiary care children’s hospital. Patients: 109 children between 0 to 2 years with a diagnosis of bronchiolitis requiring mechanical ventilation. Methods: A retrospective chart review was conducted on patients ages 0 to 2 years admitted to the PICU with a diagnosis of bronchiolitis who required invasive mechanical ventilation between May 2008 and June 2014. Data collected included demographics, ventilation duration, number and type of blood gases drawn, PaO2/FiO2 and SpO2/FiO2 ratios at the time of intubation, and arterial cannula related complications. Results: The mean duration of mechanical ventilation for patients with an arterial cannula was 7.9 (SEM±0.57) days compared to 5.9 (SEM±0.67) days in patients without an arterial cannula (p< 0.04). The average number of blood gases drawn was 2.5 times higher in the arterial cannula group (p< 0.0001). Conclusion: The presence of arterial cannulas in children intubated for bronchiolitis is associated with increased duration of mechanical ventilation and increased frequency of blood gas sampling.