Optimizing Infusate Flow Patterns for Minimizing Vein Wall Trauma: An Exploratory Study with a Modified off-Axis...

Area of Science:

• Vascular Access Devices
• Fluid Dynamics in Medicine
• Medical Device Design

Background:

• Peripheral intravenous catheters (PIVCs) are crucial for fluid administration.
• Traditional PIVC designs with central openings may cause vein wall damage due to infusate flow.
• Modifying PIVC tip design could mitigate infusate-induced vein trauma.

Purpose of the Study:

• To compare the flow patterns of a traditional PIVC with a central opening against a novel PIVC featuring an off-axis aperture.
• To evaluate the impact of PIVC tip design on infusate flow angle and proximity to the vein wall.

Main Methods:

• An exploratory observational analysis was conducted in an emergency department.
• Two types of 20-gauge PIVCs were compared: traditional (PIVC 1) and off-axis aperture (PIVC 2).
• Ultrasound imaging captured flushing dynamics to assess infusate angle, catheter tip direction, vein wall contact, and flow characteristics.

Main Results:

• The off-axis PIVC (PIVC 2) demonstrated a significantly sharper average infusate flow angle away from the vein wall (7.61°) compared to the traditional PIVC (PIVC 1) (0.20°).
• The catheter tip contacted the vein wall in 60% of traditional PIVC placements versus only 11.1% with the off-axis design.
• Flow directly at 0° to the vein wall occurred in 90% of traditional PIVCs compared to 16.7% with the off-axis PIVC.

Conclusions:

• The PIVC with an off-axis aperture significantly alters infusate flow dynamics, directing it away from the vein wall.
• This design modification shows potential for reducing vein wall trauma and associated complications.
• Further clinical studies are warranted to correlate these flow pattern findings with patient outcomes.