• Journal of critical care · Oct 2014

    Observational Study

    Difficult peripheral venous access: Clinical evaluation of a catheter inserted with the Seldinger method under ultrasound guidance.

    • Pascal Meyer, Pierrick Cronier, Hélène Rousseau, Eric Vicaut, Gerald Choukroun, Karim Chergui, Guillaume Chevrel, and Eric Maury.
    • Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France. Electronic address: pascalmeyer@voila.fr.
    • J Crit Care. 2014 Oct 1;29(5):823-7.

    PurposeA preliminary observational study was undertaken to evaluate the risk of failure of ultrasound-guided peripheral intravenous catheterization of a deep arm vein for a maximum of 7 days, after peripheral intravenous (PIV) cannulation failure.MethodsThis prospective study included patients referred to the intensive care unit for placement of a central line, a polyurethane cannula commercialized for arterial catheterization was used for peripheral venous cannulation. Catheter length and diameter were chosen based on preliminary ultrasound measurements of vein diameter and skin-vein distance.ResultsCatheterization was successful for all 29 patients. Mean vein diameter was 0.42 ± 0.39 cm; mean vein depth was 0.94 ± 0.52 cm. Mean catheter duration was 6 (median 7) days. Two occluded catheters were removed prematurely. No thrombophlebitis, catheter infection, or extravasation was observed.ConclusionOur results suggest that catheters inserted with the Seldinger method are adapted to prolonged peripheral deep-vein infusion. Ultrasound can play a role in catheter monitoring by identifying early thrombosis formation.Copyright © 2014 Elsevier Inc. All rights reserved.

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