Femoral artery pressures are more reliable than radial artery pressures oninitiation of cardiopulmonary bypass

Objective: To compare radial and femoral artery perfusion pressure during i nitiation and various stages of cardiopulmonary bypass (CPB). Design: Prospective study. Setting: The cardiac center of a tertiary referral teaching institute. Participants: Sixty consecutive patients of all ages undergoing a variety o f cardiac operations. Interventions: Radial and femoral arterial pressures were measured in all p atients on the same transducer, from the beginning to end of CPB. Measurements and Main Results: Mean perfusion pressures on CPB measured at the femoral artery at 1, 5, 10, and 15 minutes of CPB were 38.4 +/- 3.6, 46 .2 +/- 3.1,49.7 +/- 3.9, and 52.8 +/- 4.1 mmHg and were significantly great er than the corresponding radial artery pressures(29.9 +/- 4.1, 35.3 +/- 6. 1, 40.9 +/- 4.8, and 41.8 +/- 5.3 mmHg) (p < 0.001). At 30 minutes and 60 m inutes of CPB, femoral artery pressures are higher (60.3 +/- 8.8 mmHg and 6 6.4 +/- 8.2 mmHg) compared with radial artery pressures (54.7 +/- 6.9 mmHg and 59.6 +/- 6.1 mmHg), but the difference is less significant (p < 0.05). On conclusion of CPB, mean femoral artery pressures (70.9 +/- 6.7 mmHg) are greater than mean radial artery pressures (67.6 +/- 8.1 mmHg) (NS). Conclusions: Although radial artery pressures are more commonly monitored d uring cardiac surgery, femoral artery perfusion pressures are more reliable during the initial part of CPB, and routine monitoring of femoral artery p ressures may prevent vasoconstrictor use on initiation of CPB. Copyright (C ) 2000 by W.B. Saunders Company.