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Gender Disparity in Failure Rate for Arterial Catheter Attempts

Division of Pulmonary and Critical Care Medicine, Beth Israel Medical Center, New York, NY, leisen{at}gmail.com

Taro Minami, MD

Department of Internal Medicine, Beth Israel Medical Center, New York, NY

Jeffrey S. Berger, MD, MS

Division of Cardiology, Duke University Medical Center, Durham, NC

Hiroshi Sekiguchi, MD

Department of Internal Medicine, Beth Israel Medical Center, New York, NY

Paul H. Mayo, MD

Division of Pulmonary and Critical Care Medicine, Beth Israel Medical Center, New York, NY

Mangala Narasimhan, DO

Division of Pulmonary and Critical Care Medicine, Beth Israel Medical Center, New York, NY

We examined risk factors associated with failure of arterial catheterization in the medical intensive care unit of a large urban teaching hospital. We analyzed 92 consecutive arterial catheterizations by internal medicine house staff and critical care fellows. Of the 92 attempts, 26.1% were done on femoral arteries, and 73.9% were done on radial arteries. Failure, which occurred in 28% of attempts, was more common in female patients (P < .001). The failure rate was 50.0% for attempts on femoral arteries and 20.6% on radial arteries. Systolic blood pressure was significantly lower in patients where the attempt failed ( P = .024). In univariate analyses, hemoglobin values were lower (P = .028) and number of percutaneous punctures were higher (P = .019) in patients where catheterization failed. After multivariate analysis, only gender and systolic blood pressure remained statistically significant. The strongest predictor of failure was female gender. A possible explanation not explored here could be smaller arterial size in female patients.

Key Words: arterial catheterization • ultrasonography • intensive care unit • education • medical

Journal of Intensive Care Medicine, Vol. 22, No. 3, 166-172 (2007)
DOI: 10.1177/0885066607299508


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