INDICATIONS
- Continuous blood pressure measurement is necessary because of hemodynamic instability.
- Continuous blood pressure measurement is necessary for the safety of certain anesthetic techniques, such as deliberate hypotension, cardiopulmonary bypass, or major vascular surgery involving arterial clamping.
- Continuous blood pressure measurement is necessary for monitoring administration of vasoactive drugs.
- Frequent blood gas measurements are needed.
- Frequent blood sampling is needed in patients without central venous access.
- Noninvasive blood pressure monitoring is difficult or impossible, such as in patients who are severely obese, have burned extremities, or are in shock.
CONTRAINDICATIONS
- Absolute contraindications
- Infection at the site of insertion
- Traumatic injury proximal to the site of insertion
- Relative contraindications; may be outweighed by other considerations
- Failure to demonstrate collateral flow in small vessels (e.g., by Doppler ultrasonography)
- Presence of arteriovenous (AV) shunt in the limb in question
- History of surgery disrupting lymphatics of the upper extremity, such as a mastectomy with lymph node dissection
- Arterial insufficiency in the distribution of the artery to be cannulated
