Ultrasound-guided deep-arm veins insertion of long peripheral catheters in patients with difficult venous access after cardiac surgery

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• 作者：Adam Fabiani ; RN^a ; Lorella Dreas ; MD^a ; Gianfranco Sanson ; RN ; MSN^b ; ^c ; ^{gsanson@units.it}
• 关键词：Difficult venous access ; Peripheral venous catheterization ; Nursing ; Ultrasonography ; Complications
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：46
• 期：1
• 页码：46-53
• 全文大小：875 K
• 卷排序：46

文摘

To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance.BackgroundIn difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters.MethodsProspective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed.ResultsA 100% placement success rate was documented. The catheter dwell-time was 14.7 ± 11.1 days. Most catheters were removed at end-use in the absence of complications. The rate of catheters appropriately or inappropriately removed before completing the intravenous therapies was 27.7/1000 catheter-days. Two thrombophlebitis (1.91/1000 catheter-days) and 1 catheter-related bloodstream infection (0.96/1000 catheter-days) occurred.ConclusionsL-PVC could be a viable solution in DVA patients, as it may reduce the need for multiple vein punctures, patients' discomfort, and nursing workload. A better adherence to catheter management recommendations should further reduce complications.