Article Text
Abstract
Objective Establishing a peripheral intravenous catheter (PIVC) after a long intensive care unit (ICU) stay can be a challenge for nurses, as these patients may present vascular access issues. The aim of this study was to compare an ultrasound-guided method (UGM) versus the landmark method (LM) for the placement of a PIVC in ICU patients who no longer require a central intravenous catheter (CIVC).
Design Randomised, controlled, prospective, open-label, single-centre study.
Setting Tertiary teaching hospital.
Participants 114 awake patients hospitalised in ICU fulfilling the following criteria: (1) with a central venous catheter that was no longer required, (2) needing a PIVC to replace the central venous catheter and (3) with no apparent or palpable veins on upper limbs after tourniquet placement.
Intervention Placement of a PIVC using an UGM.
Primary outcome Number of attempts for the establishment of a PIVC in the upper limbs.
Results 57 patients were respectively included in both the UGM group and LM group. Stasis oedema in the upper limbs was the main cause of poor venous access identified in 80% of patients. Both the number of attempts (2 (1–4), p=0.911) and catheter lifespan ((3 (1–3) days and 3 (2–3) days, p=0.719) were similar between the two groups. Catheters in the UGM group tended to be larger (p=0.059) and be associated with increased extravasation (p=0.094).
Conclusion In ICU patients who no longer require a CIVC, use of an UGM for the establishment of a PIVC is not associated with a reduction in the number of attempts compared with LM.
Trial registration number NCT02285712; Results.
- ultrasonography
- vascular access device
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors CB, BL and AK designed the study, performed data interpretation and the writing of the manuscript. NT recorded the data. TL, AM-R and MM included patients. CB and NG performed the statistical analysis and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding CB received a grant from the French Intensive Care Society: ‘Bourse Recherche Paramédicale 2016’.
Competing interests None declared.
Patient consent Not required.
Ethics approval CPP EST III.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data are available on reasonable request from CB and NG.