Mode
Text Size
Log in / Sign up

Systematic review and meta-analysis of arterial catheter failure rates in adult critical care settingsArterial catheters fail in up to one in five cases in intensive care

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note moderate to high certainty for arterial catheter failure rates in intensive care settings.

This systematic review and meta-analysis synthesized data from studies involving 19,018 arterial catheters in an adult critical care setting. The primary focus was on arterial catheter failure and related infection outcomes. The authors analyzed pooled data to estimate failure rates and infection incidence across the included literature.

The analysis found that all-cause arterial catheter failure occurred in 13.0% of cases, with a 95% confidence interval of 7.6-19.5%. Non-infectious arterial catheter failure was observed in 19.8% of cases, with a 95% confidence interval of 12.2-28.7%. All-cause catheter-associated or related bloodstream infections occurred in 1.3% of cases, with a 95% confidence interval of 0.7-2.1%. Local infection rates were 1.2%, with a 95% confidence interval of 0.4-2.4%.

The authors identified limitations including limited reporting of definitions for bloodstream and local infections. Incidence density could not be calculated for any outcomes due to limited reporting of total catheter days. The certainty of evidence was moderate for all-cause arterial catheter failure, non-infectious arterial catheter failure, and all-cause catheter-associated or related bloodstream infections, and high for local infection. Reducing failure rates and associated complications requires system-wide interventions, clearer definitions of infection, and standardized reporting to improve data synthesis and guide evidence-based improvement.

This systematic review and meta-analysis looked at nearly 19,000 arterial catheters used in adult intensive care units. The researchers combined data from multiple studies to understand how often these devices fail or cause infections.

The analysis found that arterial catheters failed in 13.0 percent of all cases. When looking specifically at failures not caused by infection, the rate was even higher at 19.8 percent. Infection-related issues were less common but still present. All-cause catheter-associated or related bloodstream infections occurred in 1.3 percent of cases, while local infections were seen in 1.2 percent of cases.

The researchers noted that definitions for infections were not always consistent across the studies. Because of this, they could not calculate the total number of catheter days to measure infection rates more precisely. The certainty of the findings was moderate for most outcomes and high for local infections. Reducing these failure rates and complications requires system-wide changes and clearer reporting standards.

What this means for you:
Arterial catheters fail in up to one in five cases in intensive care, highlighting the need for better safety protocols.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
INTRODUCTION: Although there is an extensive body of literature on complications associated with central venous catheters, less is known about arterial catheter-related complications. This systematic review and meta-analysis aimed to quantify the incidence of arterial catheter-related complications and failure in intensive care. METHODS: Databases were searched for relevant randomised controlled trials and cohort studies that reported on arterial catheter-related complications and failure within the adult critical care setting. Two authors independently identified studies for full review, extracted data and completed quality assessments. Pooled estimates were calculated using random-effects models with the Freeman-Tukey double arcsine transformation. Certainty of evidence for each outcome was assessed using the GRADE framework. RESULTS: Thirty-nine studies (22 observational studies and 17 randomised controlled trials) comprising 19,018 arterial catheters, were included. The pooled proportion of all-cause arterial catheter failure was 13.0% (95%CI 7.6-19.5%, moderate certainty). Non-infectious arterial catheter failure occurred in 19.8% (95%CI 12.2-28.7%, moderate certainty) of arterial catheters. The pooled proportion of all-cause catheter-associated or related bloodstream infections was 1.3% (95%CI 0.7-2.1%, moderate certainty). Local infection occurred in 1.2% (95%CI 0.4-2.4%, high certainty). Reporting of definitions of bloodstream and local infections was limited. Incidence density could not be calculated for any outcomes due to limited reporting of total catheter days. DISCUSSION: Arterial catheter failure occurs in up to one in five catheters in intensive care. Reducing failure rates and associated complications requires system-wide interventions, clearer definitions of infection and standardised reporting to improve data synthesis and guide evidence-based improvement.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.