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

Overweight and Obesity Clinical Trial

— DUST  

Official title:

A Randomized, Controlled Comparison of Nurse-led Placement of Peripheral Venous Catheters in Overweight Patients Using Standard or Dynamic Ultrasound-guided Technique

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04412967
• Other study ID #: SE-2020 JG DUST
• Status: Completed
• Phase: N/A
• Start date: May 1, 2017
• Est. completion date: June 3, 2018

Study information

• Verified date: June 2020
• Source: University Hospital, Linkoeping
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 89
• Est. completion date: June 3, 2018
• Est. primary completion date: May 16, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

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)

Related Conditions & MeSH terms

• Emergencies
• Overweight
• Overweight and Obesity

Intervention

Device:
• Dynamic ultrasound-guided short-axis needle tip navigation
placement of peripheral venous catheters using ultrasound guided technique

Other:
• Standard technique of placing a PVC
Standard technique with palpation or Visual inspection of the pvc placement site

Locations

Country	Name	City	State
Sweden	University Hospital Linköping	Linköping	Östergötland

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Linkoeping

Country where clinical trial is conducted

Sweden, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time to application	Application time was defined as the time from applying stasis to visible blood in the PVC flash-chamber.	1 hour
Primary	Number of cannulation attempts	The total number of cannulation attempts performed per patient	1 hour
Secondary	Patient satisfaction	The perceived satisfaction of the patient as indicated by Numeric Rating scale (NRS, 0 = not satisfied, 10 = maximum satisfaction)	1 hour
Secondary	Perceived Pain	The perceived pain of the patient as indicated by Numeric Rating scale (NRS, 0 = no pain, 10 = the worst pain possible)	1 hour