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Using Ultrasonography for Vessel Diameter Assessment to Prevent Infiltration
Hidenori Tanabe1, Toshiaki Takahashi, Ryoko Murayama
1University of Tokyo, Graduate School of Medicine, Department of Advanced Nursing Technology, Tokyo, Japan (Drs Murayama and Oe, Mr Tanabe and Ms Arai); University of Tokyo, Graduate School of Medicine, Department of Gerontological Nursing/Wound Care Management, Tokyo, Japan (Drs Yabunaka and Sanada, Mr Takahashi); Kanazawa Medical University, School of Nursing, Kanazawa, Japan (Dr Matsui); University of Tokyo Hospital, Tokyo, Japan (Mss Uchida and Komiyama); and Terumo Corporation, Tokyo, Japan (Mr Tanabe and Ms Arai). Hidenori Tanabe, ME, is a collaborative researcher in the Department of Advanced Nursing Technology in the Graduate School of Medicine of the University of Tokyo in Tokyo, Japan. He is also a research associate at Terumo Corporation in Tokyo. Toshiaki Takahashi, MHS, RN, is a student in the Department of Gerontological Nursing/Wound Care Management in the Graduate School of Medicine of the University of Tokyo, Tokyo, Japan. Ryoko Murayama, PhD, RN, RMW, is a project associate professor in the Department of Advanced Nursing Technology in the Graduate School of Medicine of the University of Tokyo in Tokyo, Japan. Koichi Yabunaka, PhD, RT, is an assistant professor in the Department of Gerontological Nursing/Wound Care Management in the Graduate School of Medicine of the University of Tokyo in Tokyo, Japan. Makoto Oe, PhD, RN, is a project lecturer in the Department of Advanced Nursing Technology in the Graduate School of Medicine of the University of Tokyo in Tokyo, Japan. Yuko Matsui, PhD, RN, is an associate professor in the School of Nursing at Kanazawa Medical University in Kanazawa, Japan. Rika Arai, MS, is a collaborative researcher in the Department of Advanced Nursing Technology in the Graduate School of Medicine of the University of Tokyo in Tokyo, Japan, and is a research associate at Terumo Corporation in Tokyo. Miho Uchida, MSI, RN, is a vice director of nursing department at the University of Tokyo Hospital in Tokyo, Japan. Chieko Komiyama,
Choosing the right vein size can prevent IV infiltration. A vein-to-catheter ratio of 3.3 identified via ultrasound is the ideal cutoff for healthcare professionals to select appropriate veins.
Area of Science:
- Vascular access
- Medical device safety
- Ultrasound imaging
Background:
- Intravenous (IV) infiltration, a common complication, is linked to using small veins.
- Optimal vein selection criteria for preventing IV infiltration remain undefined.
- Ultrasound offers a potential method for precise vessel assessment.
Purpose of the Study:
- To determine the ideal vein diameter for preventing IV infiltration.
- To establish a quantitative ratio of vessel diameter to catheter gauge as a predictive factor for infiltration.
- To identify a specific cutoff ratio for guiding clinical practice in vein selection.
Main Methods:
- Utilized ultrasound to measure small vein diameters in patients requiring IV access.
- Calculated the ratio of measured vessel diameter to the inserted catheter gauge.
- Analyzed the correlation between this ratio and the incidence of IV infiltration using statistical methods, including multivariable analysis.
Main Results:
- A significantly lower mean vessel-to-catheter ratio was observed in patients who experienced infiltration compared to those who did not (P < .01).
- The calculated ratio emerged as an independent risk factor for IV infiltration.
- A cutoff ratio of 3.3 was identified as a critical threshold.
Conclusions:
- The vessel-to-catheter ratio is a significant predictor of IV infiltration.
- An ultrasound-guided ratio of 3.3 provides a reliable cutoff for selecting appropriate veins, thereby minimizing infiltration risk.
- This finding offers a practical, evidence-based guideline for healthcare professionals to improve patient safety during IV therapy.
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