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Ultrasound-guided PIVC insertion: a randomised controlled trial protocol.

Tricia M Kleidon1, Jessica Schults2, Claire Rickard3

  • 1Nurse Practitioner, Children's Health Queensland Hospital and Health Service, and School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.

British Journal of Nursing (Mark Allen Publishing)
|July 26, 2023
PubMed
Summary

Ultrasound-guided peripheral intravenous catheter (PIVC) insertion shows promise for improving first-attempt success in children. This technique may enhance patient outcomes and reduce healthcare costs compared to traditional methods.

Keywords:
CatheterisationClinical trial protocolPaediatric carePeripheral cathetersUltrasound

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Area of Science:

  • Pediatric Emergency Medicine
  • Medical Ultrasound Applications
  • Vascular Access Procedures

Background:

  • Peripheral intravenous catheters (PIVCs) are crucial for administering medication and fluids.
  • Traditional PIVC insertion relies on anatomical landmarks, which can be challenging in pediatric patients.
  • Limited data exist on ultrasound-guided PIVC insertion efficacy in children with difficult venous access.

Purpose of the Study:

  • To evaluate the superiority of ultrasound-guided PIVC insertion over landmark-based techniques in pediatric patients.
  • To determine if ultrasound guidance improves first-attempt success rates for PIVC insertion in children.
  • To assess secondary outcomes including insertion attempts, complications, and patient satisfaction.

Main Methods:

  • A randomized, parallel-group, single-center superiority trial involving 180 hospitalized children (0-18 years) requiring PIVC.
  • Participants were stratified by perceived difficulty of venous access and randomized 1:1 to ultrasound-guided or landmark-based PIVC insertion.
  • Primary outcome: first-attempt PIVC insertion success. Secondary outcomes: insertion attempts, failure, complications, dwell time, satisfaction, and costs.

Main Results:

  • The study aims to provide data on the effectiveness of ultrasound-guided PIVC insertion in pediatric populations.
  • It will compare first-attempt success rates between ultrasound-guided and landmark-based techniques.
  • Analysis will also cover secondary outcomes to provide a comprehensive performance evaluation.

Conclusions:

  • Ultrasound-guided PIVC insertion is hypothesized to be superior to the landmark technique for pediatric patients.
  • Successful adoption could lead to improved patient outcomes and reduced healthcare expenditures.
  • This study will inform clinical practice regarding the optimal method for PIVC insertion in children.