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Arterial Lines in ICU: How Often Do They Fail or Cause Infection?

Posted on 26 May 2026
Arterial Lines in ICU: How Often Do They Fail or Cause Infection?
Study Overview

Arterial catheters (“arterial lines”) are widely used in adult intensive care for continuous blood pressure monitoring and frequent blood sampling. While central lines have a strong evidence base on complications, arterial line complication rates are less clearly understood. This systematic review and meta-analysis pooled the available research to estimate how often arterial catheters fail and how often infections occur in adult ICU settings.

The review included 39 studies (randomised trials and observational studies) covering 19,018 arterial catheters.

Key Findings
  • Failure is not rare
    • Overall, arterial catheter failure was estimated at 13%.
  • Non-infectious failure is common
    • Non-infectious failure was estimated at 19.8%, showing many failures occur due to mechanical or functional issues rather than infection.
  • Bloodstream infection is uncommon, but still important
    • Catheter-associated bloodstream infections were estimated at 1.3%.
  • Local infection was similarly low
    • Local infection at the insertion site was estimated at 1.2%.
  • Reporting gaps limit precision
    • Many studies did not clearly define infection outcomes, and insufficient reporting meant rates per catheter-days could not be calculated.

Implications

This review suggests arterial catheter failure can affect up to one in five devices in intensive care, meaning the impact is significant at scale even when infections are relatively uncommon. The findings reinforce three priorities for improvement:

reducing mechanical and functional failure through consistent insertion and maintenance practices,
improving infection outcome definitions and reporting, and
standardising how results are documented so units can benchmark and improve over time.

Read more:https://doi.org/10.1111/anae.70074

Authors: Annabel Levido; Nicole Marsh; Amanda Corley; Felicity Edwards; Kevin B. Laupland; Samantha Keogh

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