Comparing Femoral and Radial Artery Pressure Monitoring in Adults Undergoing Elective Cardiac Surgery to Reduce Vasopressor Use

What this Trial Is About

This research focuses on adults undergoing elective cardiac surgery with cardiopulmonary bypass. It compares two methods of invasive blood pressure monitoringfemoral artery versus radial artery catheterizationto see if femoral monitoring reduces the need for norepinephrine, a vasopressor, from anesthesia induction until seven days after surgery. The study addresses concerns that radial artery measurements may underestimate central arterial pressure, potentially leading to overtreatment and complications such as acute kidney injury and cardiac events. Current evidence is mainly observational and outdated, so this study aims to provide high-quality randomized data to guide clinical practices. Participants are randomly assigned to one of two groups one receiving femoral artery catheterization and the other radial artery catheterization for continuous invasive blood pressure monitoring. The catheter is placed under ultrasound guidance in the operating room and remains in place postoperatively in the ICU until no longer needed. The study tracks patients from surgery through postoperative day seven to evaluate various outcomes related to vasopressor use, kidney and heart complications, arterial catheter-related issues, and length of hospital stay. Throughout the study, researchers collect clinical data using electronic forms. They monitor norepinephrine use, episodes of low blood pressure during surgery, cardiac complications like arrhythmias and myocardial injury, kidney injury, and complications related to arterial catheters. Secondary outcomes include vasoactive-inotropic scores, duration and dose of vasopressor therapy, ICU and hospital stays, and mortality at seven and thirty days. The total participation lasts through the first week after surgery, aiming to clarify whether femoral artery monitoring improves patient outcomes and reduces drug use compared to radial artery monitoring.

Femoral Versus Radial Invasive Arterial Pressure Monitoring in Cardiac Surgery Patients