Peripheral venous catheterization represents the preferential option for term or preterm infant care in order to start drug treatment or hydration, or perform anesthesia. However, the peripheral venous access is associated in approximately 50% of cases with a failure of the insertion on the first attempt in an emergency context. Using a micro-guide may facilitate the peripheral venous catheterization in newborns, by guiding the catheter in the vein and, thereby reduce the risk of transfixion of the vascular lumen.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
116
After antisepsis, the vein is punctured using a needle. Then the micro-guide is inserted to the first landmark, which indicates the passage of the micro-guide beyond the end of the needle. After the needle removed, the peripheral venous catheter is placed on the micro-guide. The guide is then removed, the peripheral venous catheter can be used.
After antisepsis, the catheter is introduced into the vein by a needle which is subsequently removed while the catheter remains in place.
University Hospital Montpellier
Montpellier, France
RECRUITINGSuccess of peripheral venous catheterization at the first attempt
The success of the placement is defined by the arrival of blood in the transparent chamber downstream of the needle during the placement, and by the absence of painful reaction and edema near the insertion site, indicating extravasation or extravascular passage, after flushing the catheter with 0.5 to 1 ml of isotonic saline. The success will be confirmed by retesting flush after securing the peripheral venous catheter in a dressing, within 3 to 5 minutes of successful puncture.
Time frame: Up to 5 minutes after the success of the placement
Efficiency of the technique
Assessed by the number of venipuncture attempts.
Time frame: Up to 4 days.
Efficiency of the technique
Assessed by the duration of the installation (time from the end of skin asepsis to the end of the occlusive dressing).
Time frame: Up to 4 days.
Efficiency of the technique
Assessed by the requirement to insert a central venous line directly linked to failure of peripheral venous catheterization.
Time frame: Up to 4 days.
Efficiency of the technique
Assessed by the reason for removal of peripheral venous catheter (ie, elective removal or removal for the occurrence of adverse events, see below).
Time frame: Up to 4 days.
Adverse events
Specifically associated with the micro-guide: section, intravascular migration, venous transfixion.
Time frame: Up to 4 days.
Adverse events
Common to the placement of any peripheral venous catheter, regardless of the insertion technique : puncture of an artery, pain, hemorrhage at the puncture site, phlebitis, thrombosis, infection, obstruction and subcutaneous diffusion of the infusion.
Time frame: Up to 1 month.
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