Ultrasound-detected venous changes associated with peripheral intravenous placement in children

Dewansh Goel1, Anilawan Smitthimedhin1, Bhupender Yadav1

  • 1Children's National Medical Center, Washington, DC.

British Journal of Nursing (Mark Allen Publishing)
|April 24, 2020
PubMed

Insights

Ultrasound revealed significant venous changes in pediatric patients with peripheral intravenous catheters (PIVs), including narrowing and thrombosis, which may explain device failure even without physical exam findings.

Area of Science:

  • Pediatric Medicine
  • Vascular Imaging
  • Medical Devices

Background:

  • Peripheral intravenous catheters (PIVs) are essential for pediatric patient care but often fail before treatment completion.
  • The underlying causes of PIV failure in children are not fully understood.
  • Ultrasound (US) imaging may reveal subclinical venous changes associated with PIV use.

Purpose of the Study:

  • To describe and document venous changes in pediatric patients using PIVs via ultrasound imaging.
  • To investigate the correlation between PIV dwell time and observed venous alterations.

Main Methods:

  • A prospective study involving ultrasound scans of PIV-containing veins in pediatric patients.
  • Evaluation of venous characteristics including diameter, wall thickness, blood flow, and presence of thrombus.
  • Recording of patient demographics and PIV details.

Main Results:

  • Ultrasound identified venous changes in 73% of accessed veins in 30 pediatric patients.
  • Common findings included lumen narrowing (47%), wall thickening (33%), and thrombus formation (20%).
  • Absence of blood flow around the PIV tip was observed in 40% of cases.

Conclusions:

  • Ultrasound can detect significant venous changes in pediatric patients with PIVs, often not apparent on physical examination.
  • These US-detectable venous alterations, such as narrowing and thrombosis, likely contribute to PIV malfunction and failure.
  • Further research with larger sample sizes is warranted to fully characterize these findings and their clinical implications.
Abstract

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