Ultrasound assessment of short peripheral catheter failure.

Autor:	Giustivi D; Post Anesthesia Care Unit and Vascular Access Team ASST Lodi, Lodi, Italy., Celano R; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Cattalani M; University of Milan, ASST Fatebenefratelli Sacco Section, Luigi Sacco Hospital, Milan, Italy., Camilli C; University of Milan, ASST Fatebenefratelli Sacco Section, Luigi Sacco Hospital, Milan, Italy., Trombetta L; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Facchinetti P; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Bartoli A; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Bizzi E; Internal Medicine Department, Fatebenefratelli Hospital, Milan, Italy., Urso F; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Donadoni M; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Quici M; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., La Cava L; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Calloni M; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Martini E; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Taino A; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Cogliati C; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy., Gidaro A; Department of Biomedical and Clinical Sciences 'Luigi Sacco,' University of Milan, Luigi Sacco Hospital, Milan, Italy.
Jazyk:	angličtina
Zdroj:	The journal of vascular access [J Vasc Access] 2024 Aug 03, pp. 11297298241261146. Date of Electronic Publication: 2024 Aug 03.
DOI:	10.1177/11297298241261146
Abstrakt:	Introduction: Short peripheral catheters (SPCs) are affected by a high complication rate that leads to catheter failure. Currently, the Visual Infusion Phlebitis score (VIP) is the most used tool to verify the presence of inflammatory complications (phlebitis and thrombophlebitis). However, ultrasound signs (US) may be an attractive alternative. Objective: This study aims to evaluate the sensitivity and specificity of US and VIP score = 1 in identifying and recognizing early signs of SPC failure. The time to positivity for US and VIP scores was assessed as a secondary outcome. Methods: An observational prospective study was conducted. In each patient, US (subcutaneous edema; fibroblastic sleeve; thrombophlebitis) and VIP of the exit site were performed every 24 h until 96 h after insertion. Compared to catheter failure, Sensitivity, Specificity, and Predictive values in both US and VIP were calculated. Results: Two hundred patients were enrolled. The presence of ultrasonic pattern suggestive of edema at 72 h ( p  = 0.018), fibroblastic sleeve at 24, 48, 72, and 96 h ( p <  0.001), thrombosis at 48 ( p <  0.001) and 72 h ( p  = 0.005), and at least one of an abovementioned US at all checkpoints ( p <  0.001) were highly significant predictors of complications. Both US and VIP effectively detect inflammatory events; however, the US showed better sensitivity in overall checkpoints and earlier predictive ability than VIP (1.9 vs 0.47 days). Conclusions: An ultrasound inflammatory pattern is correlated with SPC failure. An ultrasound protocol-requiring minimal training-is more effective than VIP in recognizing early signs of device failure. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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