Arterial Pressure Monitoring During Cardiopulmonary Bypass Using Axillary Arterial Cannulation

摘要

Femoral arterial cannulation had been used as the alternate source of arterial inflow for cardiopulmonary bypass (CPB) when the ascending aorta or arch was unsuitable for various reasons. Right, or rarely left, axillary arterial cannulationshave become more common, especially when the femoral arteries are not available for arterial cannulation due to severe iliofemoral arterial disease or in patients who have severe atherosclerotic disease of the descending thoracic aorta with floating debris that precludes safe retrograde arterial perfusion.Right axillary artery cannulation may be the arterial inflow of choice in patients with aortic dissections and aortic aneurysms when selective cerebral perfusion may be necessaryduring deep hypothermic circulatory arrest (DHCA). The authors report a case in which monitoring of the ipsilateral radial arterial pressure in a patient on CPB using axillary cannulation resulted in falsely elevated arterial blood pressures that led to inappropriate hemodynamic management and hypoxic cerebral injury.