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Ultrasound-guided placement of peripherally inserted intravenous catheters increase catheter dwell time in children

James Thomas Cottrell1, Todd Chang2, Jennifer Baird1

  • 1Children's Hospital Los Angeles, Los Angeles, CA, USA.

The Journal of Vascular Access
|June 25, 2020
PubMed

Insights

Ultrasound-guided peripheral intravenous catheters in children stayed in significantly longer than non-ultrasound-guided ones. This suggests increased use of ultrasound guidance may improve pediatric IV therapy.

Area of Science:

  • Pediatric Medicine
  • Vascular Access
  • Medical Imaging

Background:

  • Short peripheral intravenous catheters (PIVCs) are crucial for hospitalized children.
  • Optimizing PIVC dwell time is essential for reducing complications and improving patient care.
  • Current practices for PIVC insertion vary, impacting their longevity.

Purpose of the Study:

  • To compare the dwell times of ultrasound-guided (US) versus non-ultrasound-guided (non-US) PIVCs in hospitalized children.
  • To evaluate the impact of US guidance on PIVC longevity in a pediatric population.

Main Methods:

  • Retrospective analysis of 256 US-guided and 287 non-US-guided PIVCs in hospitalized children.
  • Statistical comparison of dwell times using independent t-test and Kaplan-Meier estimator.
  • Analysis of covariates including patient age, PIVC location, and placement difficulty.

Main Results:

  • US-guided PIVCs demonstrated significantly longer mean dwell times (96.06 hours) compared to non-US-guided PIVCs (59.39 hours).
  • The mean increase in dwell time with US guidance was 36.68 hours.
  • Median dwell times were 118 hours for US-guided and 71 hours for non-US-guided PIVCs.

Conclusions:

  • Ultrasound guidance significantly increases the dwell time of peripheral intravenous catheters in pediatric patients.
  • Findings align with adult literature, supporting wider adoption of US-guided PIVC placement in pediatrics.
  • US guidance may enhance the efficiency and effectiveness of IV therapy in children.
Abstract

Keywords:
Ultrasounddwell timeintravenous catheterpoint-of-care ultrasound

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