Introduction: Extending the traditional dwell of peripheral venous catheters from routine replacement has been shown to be successful without increasing risk to patient safety. One group of patients that can benefit from extending catheter dwell are those with difficult venous access, who may endure multiple, painful cannulation attempts. We report our experience on the use of two peripheral devices for extended dwell in patients with difficult venous access.
Methods: The devices chosen and available to the Australian market during the study period were the 100 mm PowerGlide® midline catheter and the 48 mm Nexiva® catheter in both 18 and 20 gauges. Catheter selection was based on ultrasound assessment of vessel depth from skin and diameter. Patient information and catheter characteristics were collected and presented as numbers, ranges and proportions. Non-parametric tests were used to assess differences in catheter groups where appropriate.
Results: Between November 2015 and August 2016, 192 patients had extended dwell peripheral catheters inserted. PowerGlide® catheters were the primary devices placed (n=161, 84%) compared to Nexiva® catheters and the basilic vein was the vessel of choice (n=175, 90%). Primary reasons for device placement were difficult venous access requiring infusion therapy as well as antibiotic therapy. Median dwell of all devices was six days (IQR 3–11 days) and 68% of devices (n=131) were removed for cessation of intravenous therapy.
Conclusion: The majority of devices were placed on first attempt and a number were successfully managed for weeks until cessation of therapy. Rates of phlebitis were minimal, and no infections were reported.
Keywords: Intravenous catheter, peripheral venous catheter, ultrasound.
Conflict of interest
Evan Alexandrou is a member of the Alliance for Vascular Access Teaching and Research (AVATAR) group, which has previously received unrestricted, investigator-initiated research or educational grants from product manufacturers (3M; Adhezion; AngioDynamics;
Baxter; BBraun; Becton Dickinson; CareFusion; Centurion Medical Products; Cook Medical; Entrotech; Medtronic; Smiths Medical).
Funding source
The authors wish to declare no funding was sought or received for this study.
Authors’ contributions
All authors have made substantial contributions to the study conception and design, acquisition of data and analysis and interpretation of data. Each author has contributed to drafting and editing the manuscript and approves the final version for publishing as per the International Committee of Medical Journal Editors (ICMJE) convention.