Standard long IV catheters versus extended dwell catheters: A randomized comparison of ultrasound-guided catheter survival

Abstract

A longer extended dwell catheter represents a viable and favorable alternative to the standard longer IVs used for US-guided cannulation of veins >1.20 cm in depth. These catheters have significantly improved survival rates with similar insertion success characteristics.

Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access

“…Accessing the brachial vein requires a high level of expertise as there is a significant risk of brachial artery and median nerve injury . When attempting cannulation of a deep vein with a short IV catheter, there is a risk of catheter failure . Increased vein depth correlates with a decreased amount catheter length within the vein and hence poorer catheter survival due to risk of extravasation from the vein with movement .…”

“…Given the small size and compressibility of veins in children, posterior wall puncture can occur quite easily and cause a significant hematoma that may make further attempts difficult . The rate of posterior wall puncture may increase in novice ultrasound users who cannot differentiate needle tip from needle shaft …”

“…21 Increased vein depth correlates with a decreased amount catheter length within the vein and hence poorer catheter survival due to risk of extravasation from the vein with movement. 21 Midline catheters, which are shorter than a PICC line but longer than a peripheral cannula, are a safe potential alternative when attempting access of deeper veins. 22 Appropriate ultrasound probe selection is another important step to take for successful US-guided PIV placement.…”

“…18 The rate of posterior wall puncture may increase in novice ultrasound users who cannot differentiate needle tip from needle shaft. 21 ( Figure 4) Finally, the wire is removed, and extension tubing secured at the catheter hub. This less commonly used technique carries a risk of hematoma and subsequent inability to catheterize the vein and should therefore be best used as a rescue technique.…”

Ultralong Versus Standard Long Peripheral Intravenous Catheters: A Randomized Controlled Trial of Ultrasonographically Guided Catheter Survival

“…1 Nearly 90% of all hospitalized patients require intravenous access for treatment, with up to one third qualifying as having difficult vascular access, and in 75% of whom the traditional palpation method of intravenous line insertion fails and ultrasonographically guided intravenous peripheral catheter insertion offers improved success. Although ultrasonographically guided intravenous peripheral catheter placement is successful in 76% to 100% of patients with difficult vascular access, [2][3][4][5][6] the catheter dwell rate is concerning, with 46% to 56% of catheter failures occurring prematurely compared with intravenous line failure rates of 19% to 25% [2][3][4]7,8 with nondifficult vascular access. Causes of catheter failure include infiltration, dislodgment, phlebitis, and infection.…”