Using Ultrasonography for Vessel Diameter Assessment to Prevent Infiltration

Small veins are a risk factor for infiltration. However, there are no data regarding the ideal vein diameter for preventing infiltration. Using ultrasound, vessel diameter and calculated ratios of the vessel diameter to the catheter gauge were measured. The relationship between the ratio and infiltration was assessed to establish a cutoff point. The mean ratio of the infiltration group was significantly smaller than that of the no-infiltration group (P < .01), and the ratio was an independent risk factor according to the multivariable analysis. The ratio of 3.3 was determined to be the cutoff point that enables health care professionals to identify veins appropriately.

[1]  Donna Wilson,et al.  The Use of Ultrasound to Improve Practice and Reduce Complication Rates in Peripherally Inserted Central Catheter Insertions: Final Report of Investigation , 2009, Journal of infusion nursing : the official publication of the Infusion Nurses Society.

[2]  F. Lombardo,et al.  Extravasation of chemotherapeutic agents: prevention and treatment. , 2006, Seminars in oncology.

[3]  Lynn Hadaway,et al.  Infiltration and extravasation: update on prevention and management. , 2009, Journal of infusion nursing : the official publication of the Infusion Nurses Society.

[4]  B. Risberg.  Pathophysiological mechanisms of thromboembolism. , 1989, Acta chirurgica Scandinavica. Supplementum.

[5]  Lynn Hadaway,et al.  Infiltration and extravasation. , 2007, The American journal of nursing.

[6]  N. Everitt.  Effect of prolonged infusion on vein calibre: a prospective study. , 1999, Annals of the Royal College of Surgeons of England.

[7]  L. Mazzolai,et al.  Randomized controlled trial of peripherally inserted central catheters vs. peripheral catheters for middle duration in‐hospital intravenous therapy , 2008, Journal of thrombosis and haemostasis : JTH.

[8]  E. Walker.  Piloting a nurse-led ultrasound cannulation scheme. , 2009, British journal of nursing.

[9]  W. Raub.  From the National Institutes of Health. , 1990, JAMA.

[10]  C. Metz.  ROC Methodology in Radiologic Imaging , 1986, Investigative radiology.

[11]  James A. Evans,et al.  Ultrasonographic investigation of the pathogenesis of infusion thrombophlebitis , 1997, The British journal of surgery.

[12]  S. Talbot,et al.  Pediatric Compartment Syndrome Caused by Intravenous Infiltration , 2011, Annals of plastic surgery.

[13]  D. Larson,et al.  Etiology and treatment of chemotherapeutic agent extravasation injuries: a review. , 1987, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  E. Hoeck,et al.  Outcomes of Using a Modified Seldinger Technique for Long Term Intravenous Therapy in Hospitalized Patients with Difficult Venous Access , 2012 .

[15]  J. Macfie,et al.  ESPEN Guidelines on Parenteral Nutrition: central venous catheters (access, care, diagnosis and therapy of complications). , 2009, Clinical nutrition.

[16]  Handler Eg.  Superficial compartment syndrome of the foot after infiltration of intravenous fluid. , 1990, Archives of physical medicine and rehabilitation.

[17]  E. Handler.  Superficial compartment syndrome of the foot after infiltration of intravenous fluid. , 1990, Archives of Physical Medicine and Rehabilitation.

[18]  M. Wallis,et al.  Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial , 2012, The Lancet.

[19]  Didier Pittet,et al.  Peripheral venous catheters: an under-evaluated problem. , 2009, International journal of antimicrobial agents.

[20]  S. Dychter,et al.  Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access , 2012, Journal of infusion nursing : the official publication of the Infusion Nurses Society.

[21]  R. Mason,et al.  The endothelium: roles in thrombosis and hemostasis. , 1977, Archives of pathology & laboratory medicine.

[22]  T. Royer.  Improving Short Peripheral IV Outcomes: A Clinical Trial of Two Securement Methods , 2003 .

[23]  G. D. LaRue,et al.  The impact of dilution on intravenous therapy. , 2011, Journal of infusion nursing : the official publication of the Infusion Nurses Society.

[24]  L. Dougherty.  IV therapy: recognizing the differences between infiltration and extravasation. , 2008, British journal of nursing.

[25]  L. Gorski.  Infusion nursing standards of practice. , 2007, Journal of infusion nursing : the official publication of the Infusion Nurses Society.