Venous Catheterization
Conditions
Keywords
Peripheral venous catheter, ultrasound, nurse, Intensive Care Units
Brief summary
Peripheral intravenous access is a major intervention in patients admitted to an intensive care unit. Systematically performed by nurses, it is also an essential intervention when the central venous access has to be removed. However, in the intensive care unit, patient centered-characteristics such as previous history of intravenous drug abuse, obesity, history of multiple vascular punctures or fluid overload most often affect the success rate of this procedure. For these patients, failure consequences are numerous: 1) delayed discharge from the intensive care unit, 2) increased pain and dissatisfaction, 3) increased incidence of catheter-related bloodstream infections. The use of ultrasound has gained increasing popularity particularly for obtaining central venous access. We hypothesize that, among trained nurses, ultrasound-guided peripheral venous access could represent an attractive alternative compared to the traditional anatomical method in order to increase the success rate.
Interventions
DEVICEVascular ultrasound system
Sponsors
Central Hospital, Nancy, France
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patient admitted in ICU * patient not able to express his opposition * central venous access that need to be removed * need for a peripheral venous access * no clinical instability * no visible superficial vein due to: BMI\> 30, fluid overload, previous history of IV drug abuse, previous history of chemotherapy ,
Exclusion criteria
* patient \< 18 yo * pregnancy * patient under protective supervision * need for a central venous access
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number of peripheral venous catheterization attempts | up to day 2 | Each day, only 3 attempts are allowed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| central venous catheter dwell time | intraoperative | defined period between insertion and removal of the central venous line |
| peripheral venous catheter dwell time | intraoperative | defined period between insertion and removal of the peripheral catheter with a maximum of 3 days. |
| number of central line catheter related infection | intraoperative | — |
| number of central line catheter related colonization | intraoperative | — |
| Number of central lines removed | intraoperative | — |
| patient satisfaction | intraoperative | assessed by an analogic scale |
| nurse satisfaction | intraoperative | assessed by a survey form |
| Proportion of peripheral venous catheter successful placement | at day 0, day 1, day 2 | — |
| Diameter of the inserted peripheral venous catheter | day 0, or day 1 or day 2 | at peripheral venous catheter insertion |
Countries
France
Outcome results
None listed