Different authors with healthy adults specifically reported no complications such as premature removal of catheters, ecchymosis or hematoma, or the persistence of pain after catheter removal. 10, 11, 12 The authors reported no femoral catheter related complications despite repetitive and acute hip flexion in these protocols. Studies in healthy human subjects with a cannulated femoral artery or vein were performed to evaluate physiologic effects using leg resistance exercises in a sitting position or during upright positioning on a treadmill. Our review of the literature within the fields of critical care medicine, nursing, and physical therapy has yet to find published reports of adverse outcomes related to mobility of patients with femoral arterial catheters in the ICU. Restriction of either limb or whole body mobility in patients with femoral cannulation is often due to unsubstantiated concerns about kinking or breaking the catheter, accidental loss of access, line disconnection with subsequent bleeding, occlusion or thrombosis formation, vessel injury (eg, pseudoaneurysm, especially from rigid catheters), and increased potential for site contamination related to dressing dislodgement. The purpose of this study was to examine the incidence of femoral catheter related adverse effects during physical therapy interventions for adult patients in a cardiovascular ICU. 7, 8, 9 There are limited data describing the safety or tolerance to mobility interventions provided to critically ill adults with femoral catheters. 6 Venous access is used to administer medications or fluid, allow blood sampling, monitor pressure, and provide access for dialysis. 1, 2, 3, 4, 5 Femoral arterial catheterization for hemodynamic monitoring is the most commonly used location after the radial artery, particularly in medical ICU settings. Cannulation of arterial and venous femoral vessels has been identified as a potential and actual barrier to hip flexion, sitting, standing and walking for patients in the intensive care unit (ICU). The decision about location of cannulation site is made by a physician and is usually related to individual patient considerations. These catheters are required in the management of life saving treatments but can also be associated with infections, thromboses, and mechanical complications. Central arterial and venous catheters are used in the treatment of critically ill patients.
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