Peripheral IV access for apheresis
Abstract:
Background: Apheresis procedures require adequate vascular access to achieve adequate inlet flow rates. Central dialysis-type catheters are often used in apheresis, despite their multiple risks. Peripheral venous access is a safe and effective option for many patients.
Aim: We previously demonstrated that ultrasound guidance reduces central venous catheter use in apheresis patients; however, no validated criteria for preprocedural evaluation of peripheral veins exist. Here, we hypothesized that ultrasound-based criteria could predict the adequacy of a peripheral vein for apheresis procedures.
Patients/methods: In this pilot cohort study, we reviewed the procedural outcomes for 50 cases of peripheral venous procedures that used our ultrasound-based criteria.
Results: Of the procedures that met our criteria, 96% (46/48) were successfully completed. Overall, our criteria had 100% sensitivity, 50% specificity, 96% positive predictive value, and 100% negative predictive value.
Conclusion: Our criteria justify an evidence-based ultrasound-guided standard for evaluation of peripheral venous access for apheresis procedures.
Reference:
Salazar E, Gowani F, Segura F, Passe H, Seamster L, Chapman B, Joubert F, Hopson S, Easley T, Garcia S, Miguel R, Medina C, Musharbash A, Castillo B, Chen J, Ipe T, Leveque C. Ultrasound-based criteria for adequate peripheral venous access in therapeutic apheresis procedures. J Clin Apher. 2021 Aug 4. doi: 10.1002/jca.21930. Epub ahead of print. PMID: 34347310.