INTRODUCTION: Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity. METHODS: A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed. RESULTS: After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% (36/151) had been removed for routine reasons, and 44% (67/151) remained in working condition yielding a survival probability of 0.63 (95% confidence interval [CI], 0.53-0.70). Survival probability was perfect (1.00) when placed in shallow vessels (<0.4 cm), moderate (0.62; 95% CI, 0.51-0.71) for intermediate vessels (0.40-1.19 cm), and poor (0.29; 95% CI, 0.11-0.51) for deep vessels (≥1.2 cm); P < .0001. Intravenous survival probability was higher when placed in the antecubital fossa or forearm locations (0.83; 95% CI, 0.69-0.91) and lower in the brachial region (0.50; 95% CI, 0.38-0.61); P = .0002. The impact of vessel depth and location was significant after 3 hours and 18 hours, respectively. Vessel diameter did not affect USGPIV longevity. CONCLUSION: Cannulation of deep and proximal vessels is associated with poor USGPIV survival. Careful selection of target vessels may help improve success of USGPIV placement and durability.
INTRODUCTION: Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity. METHODS: A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed. RESULTS: After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% (36/151) had been removed for routine reasons, and 44% (67/151) remained in working condition yielding a survival probability of 0.63 (95% confidence interval [CI], 0.53-0.70). Survival probability was perfect (1.00) when placed in shallow vessels (<0.4 cm), moderate (0.62; 95% CI, 0.51-0.71) for intermediate vessels (0.40-1.19 cm), and poor (0.29; 95% CI, 0.11-0.51) for deep vessels (≥1.2 cm); P < .0001. Intravenous survival probability was higher when placed in the antecubital fossa or forearm locations (0.83; 95% CI, 0.69-0.91) and lower in the brachial region (0.50; 95% CI, 0.38-0.61); P = .0002. The impact of vessel depth and location was significant after 3 hours and 18 hours, respectively. Vessel diameter did not affect USGPIV longevity. CONCLUSION: Cannulation of deep and proximal vessels is associated with poor USGPIV survival. Careful selection of target vessels may help improve success of USGPIV placement and durability.
Authors: Christopher Raio; Robert Elspermann; Natwalee Kittisarapong; Brendon Stankard; Tanya Bajaj; Veena Modayil; Mathew Nelson; Gerardo Chiricolo; Benjamin Wie; Alexandra Snock; Michael Mackay; Adam Ash Journal: Intern Emerg Med Date: 2017-09-14 Impact factor: 3.397
Authors: Christopher M Fung; Douglas R Stayer; Jason J Terrasi; Prasad R Shankar; James A Cranford; Michael T Cover; Ryan V Tucker; Robert D Huang; Nik Theyyunni Journal: Am J Emerg Med Date: 2021-05-06 Impact factor: 4.093
Authors: Giancarlo Scoppettuolo; Mauro Pittiruti; Sara Pitoni; Laura Dolcetti; Alessandro Emoli; Alessandro Mitidieri; Ivano Migliorini; Maria Giuseppina Annetta Journal: Int J Emerg Med Date: 2016-02-04
Authors: Peter J Carr; James C R Rippey; Marie L Cooke; Chrianna Bharat; Kevin Murray; Niall S Higgins; Aileen Foale; Claire M Rickard Journal: BMJ Open Date: 2016-02-11 Impact factor: 2.692