Sécurisation des procédures « circulatoires » (administration des drogues vasoactives, utilisation des cathéters artériels, veineux centraux et artériels pulmonaires)

Arterial and central venous catheterizations and their use for continuous infusion of vasoactive drugs could lead to serious adverse events that could be life-threatening. The incidence of human errors related patient adverse events could be decreased by the use of algorithms and procedures. Concerning the continuous infusion of vasoactive drugs, the name of drug and its concentration should be clearly notified. The use of modern pomp and noncompliant pipe could reduce the frequency of bolus and their related hemodynamic alterations. Reasonable procedure could reduce the arterial and central venous catheters related complications. Subclavian and radial sites should be preferred for central venous and arterial catheter insertion, respectively. The use of real time echographic guidance could facilitate the catheter insertion. These catheters should be removed when they are not indicated. Concerning the pulmonary artery catheter, the balloon tip should be inflated with visual control of the pulmonary artery pressure. Its removal is recommended within the first five days.