Intra-arterial catheters: An evidence-based review of device design, function and application

Table 3 Important aspects in the daily care of arterial lines

Daily care	Explanation
Dressings	The optimal dressing products, frequency of dressing changes and frequency of site inspections are uncertain. A common practice is to replace dressings weekly or sooner if they become loose or unclean. Local institutional policies should be followed. A topical cleansing agent should be applied to the catheter site during a dressing change to prevent infection[76,83]
Antibiotic prophylaxis	Daily antimicrobial prophylaxis to prevent infection while the arterial line is in situ is not advised, as evidence is insufficient
Securement	Both sutures and adhesive dressings are suitable methods for catheter securement. No consistent differences in adverse events have been demonstrated[84]. Sutures were associated with fewer arterial line displacements in retrospective studies compared with sutureless fixation dressings but may predispose to infection
Flushing	A continuous slow infusion of normal saline is delivered through the arterial line to maintain patency. A pressure bag attached to the transducer system is commonly inflated to 300 mmHg to deliver fluid at a rate of ~3 mL/hour. This configuration reduced adverse events compared with intermittent flushes or infusion rates[85,86]. Heparin does not improve patency over normal saline[87]
Routine catheter changes	Routine arterial line changes are not recommended. Regular arterial line replacement does not reduce the risk of catheter-related sepsis as opposed to a process of replacement only when clinically indicated[88-90]. The relationship between catheter dwell time and the incidence of infection is unclear