Depth of Anesthesia 28: What is the infectious risk of arterial catheters?
Mar 11, 2022
Elisa Walsh, Surgical ICU fellow and former MGH anesthesia chief resident, offers clinical perspective on arterial line infection risks and sterile practice. Benjamin Weaver, anesthesiology resident, reviews the literature and trial data. They discuss how arterial catheter infection rates compare to central lines, clinician perceptions and survey findings, and the mixed evidence on whether full barrier precautions reduce arterial infections.
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Underestimated Infection Risk
- Arterial lines are commonly perceived as low infection risk compared to central lines.
- This perception is widespread among clinicians despite limited awareness of actual rates.
Meta-Analysis Shows Similar Rates
- A 2014 meta-analysis found arterial catheter-related bloodstream infections at ~0.96 per 1,000 catheter days.
- This rate overlaps with reported central line infection ranges, so arterial risk is nontrivial.
Colonization Predicts Bloodstream Infection
- Catheter tip colonization correlates moderately with bloodstream infection (R=0.69).
- Colonization can serve as a useful surrogate outcome when bloodstream infection data are limited.