Artticolo recente a riguardo della durata dei cateteri periferici applicati in ecoguida che conclude che la migliore "sopravvivenza" dei catetri è determinata dall'accuratezza della scelta del vaso da incannulare.
Alcune osservazioni: non ho visto riportato la tipologia di terapia utilizzata (continua vs discontinua), la tipologia delle infusioni, il rapporto tra diametro vena e diametro catetere, il numero di tentativi per l'impianto, concomitanza o meno di fenomeni infettivi.
Buona lettura
Am J Emerg Med. 2012 Sep;30(7):1134-40. doi: 10.1016/j.ajem.2011.07.027. Epub 2011 Nov 10.
The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity.
Source
Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA. matthewfields@gmail.com
Abstract
INTRODUCTION:
Ultrasound-guided peripheral intravenous catheters (USGPIVs) have been observed to have poor durability. The current study sets out to determine whether vessel characteristics (depth, diameter, and location) predict USGPIV longevity.
METHODS:
A secondary analysis was performed on a prospectively gathered database of patients who underwent USGPIV placement in an urban, tertiary care emergency department. All patients in the database had a 20-gauge, 48-mm-long catheter placed under ultrasound guidance. The time and reason for USGPIV removal were extracted by retrospective chart review. A Kaplan-Meier survival analysis was performed.
RESULTS:
After 48 hours from USGPIV placement, 32% (48/151) had failed prematurely, 24% (36/151) had been removed for routine reasons, and 44% (67/151) remained in working condition yielding a survival probability of 0.63 (95% confidence interval [CI], 0.53-0.70). Survival probability was perfect (1.00) when placed in shallow vessels (<0.4 cm), moderate (0.62; 95% CI, 0.51-0.71) for intermediate vessels (0.40-1.19 cm), and poor (0.29; 95% CI, 0.11-0.51) for deep vessels (≥1.2 cm); P < .0001. Intravenous survival probability was higher when placed in the antecubital fossa or forearm locations (0.83; 95% CI, 0.69-0.91) and lower in the brachial region (0.50; 95% CI, 0.38-0.61); P = .0002. The impact of vessel depth and location was significant after 3 hours and 18 hours, respectively. Vessel diameter did not affect USGPIV longevity.
CONCLUSION:
Cannulation of deep and proximal vessels is associated with poor USGPIV survival. Careful selection of target vessels may help improve success of USGPIV placement and durability.
Copyright © 2012 Elsevier Inc. All rights reserved.
- PMID:
- 22078967
- [PubMed - indexed for MEDLINE]
