Nurse-led Placement of Peripheral Venous Catheters in Overweight Patients Using Standard or Dynamic Ultrasound-guided Technique

Not Applicable

Completed

• Conditions: Emergencies; Overweight and Obesity
• Interventions: Device: Dynamic ultrasound-guided short-axis needle tip navigation; Other: Standard technique of placing a PVC

• Registration Number: NCT04412967
• Lead Sponsor: University Hospital, Linkoeping

Brief Summary

Overweight and obesity may be associated with difficult intravenous access leading to longer procedure time and more placement attempts of peripheral venous catheters (PVC). Dynamic ultrasound-guided short-axis needle tip navigation (DUST) may facilitate the procedure.

This was a prospective, randomized, non-blinded study to compare time and placement attempts for nurse-led standard (ST) and ultrasound guided PVC placement in 90 emergency patients with a BMI ≥25kg/m2.

Consenting patients were randomized at a 1:1 ratio to receive PVC by either ST or DUST.

Application time was defined as the time from applying stasis to visible blood in the PVC flash-chamber.

No difference in time was found (medians: ST 42 s; DUST 53.5 s, P = 0.535). There were on average 17 % less placement attempts in the DUST-group (median 1 attempt; Q1 = 1 Q3 = 1) compared to the ST-group (median 1 attempt; Q1 = 1 Q3 = 1.5), (p = 0.031). Patients reported no differences in perceived pain (p = 0.955) or perceived satisfaction (p = 0.342). Pain and subcutaneous infiltrations were the only side-effects reported (ST-group 6, DUST-group 5).

DUST does not decrease time to functional PVC but reduces the number of PVC placement attempts in patients with BMI ≥25 kg/m2.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-05-01
• Primary Completion: 2018-05-16
• Study Completion: 2018-06-03
• Study First Submitted: 2020-05-27
• Status Verified: 2020-06
• Study First Submitted QC: 2020-06-01
• Study First Posted: 2020-06-02
• Last Update Submitted: 2020-06-26
• Last Update Posted: 2020-06-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 89

Inclusion Criteria

• REETS prioritization level of "Orange", "Yellow", "Green" or "Blue"
• 18 years old
• BMI ≥25 Kg/m2
• Need of PVC according to Emergency department guidelines
• Able to give written informed consent

Exclusion Criteria

• Unable or unwilling to provide informed consent
• Life threatening patient status (REETS prioritization level of "Red")
• Immunosuppression
• Pregnant or lactating women
• Blood infections
• Puncture zone skin damaged (burns, eczema, infection)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
DUST	Dynamic ultrasound-guided short-axis needle tip navigation	Dynamic ultrasound-guided short-axis needle tip navigation (DUST)
Standard Technique PVC placement	Standard technique of placing a PVC	Standard PVC placement technique

Primary Outcome Measures

Name	Time	Method
Number of cannulation attempts	1 hour	The total number of cannulation attempts performed per patient
Time to application	1 hour	Application time was defined as the time from applying stasis to visible blood in the PVC flash-chamber.

Secondary Outcome Measures

Name	Time	Method
Perceived Pain	1 hour	The perceived pain of the patient as indicated by Numeric Rating scale (NRS, 0 = no pain, 10 = the worst pain possible)
Patient satisfaction	1 hour	The perceived satisfaction of the patient as indicated by Numeric Rating scale (NRS, 0 = not satisfied, 10 = maximum satisfaction)

Trial Locations

Locations (1)

University Hospital Linköping; 🇸🇪 Linköping, Östergötland, Sweden