Arterial Catheters in ICUs: How Common and How Safe?

Study Overview

This large-scale point prevalence study examined arterial catheter (AC) use across 59 ICUs in Australia and New Zealand. Conducted in partnership with the George Institute and ANZICS, the study aimed to determine how frequently ACs are used, their associations with illness severity, and how they are managed.

Key Findings

High usage: 68% of ICU patients had an AC in place—more than were ventilated or on vasopressors.

Radial site dominance: Most ACs were placed in the radial artery (87%).

Higher illness severity: Patients with ACs had higher APACHE-II and SOFA scores, longer ICU stays, and greater odds of mechanical ventilation and vasopressor use.

Wide practice variation: There were 25 different dressing and securement combinations across ICUs. Only 36% of units followed weekly dressing changes, and many relied on clinical judgment for removal.

Outcomes: AC use was associated with higher ICU mortality (13% vs 4.8%) and lower hospital discharge rates at 28 days.

Implications

The study highlights a potential overuse of ACs, especially in patients not on mechanical support. It underscores the need for standardised, evidence-based guidelines for insertion, dressing, maintenance, and timely removal of ACs.

Read more: https://www.australiancriticalcare.com/article/S1036-7314(25)00142-0/fulltext 

Authors: Samantha Keogh, Felicity Edwards, Annabel Levido, Evan Alexandrou, Amanda Corley, Fiona Coyer, Jayesh Dhanani, Kristen Gibbons, Naomi E. Hammond, Serena Knowles, Kevin B. Laupland, Mahesh Ramanan, Claire M. Rickard, Andrew Udy