Vessel depth, diameter, and location: Ultrasound-guided peripheral IV outcomes

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Intravenous literature: Fields, J.M., Dean, A.J., Todman, R.W., Au, A.K., Anderson, K.L., Ku, B.S., Pines, J.M. and Panebianco, N.L. (2011) The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity. The American Journal of Emergency Medicine. Nov 10. [Epub ahead of print].

Abstract:

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 (

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.

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