title: Standard-length catheters vs long catheters in ultrasound-guided peripheral vein cannulation.
abstract: OBJECTIVE
  Ultrasound (US) is a useful tool for peripheral vein cannulation in patients with difficult venous access. However, few data about the survival of US-guided peripheral catheters in acute care setting exist. Some studies showed that the survival rate of standard-length catheters (SC) is poor especially in obese patients. The use of longer than normal catheters could provide a solution to low survival rate. The aim of the present study was to compare US-guided peripheral SCs vs US-guided peripheral long catheters inserted with Seldinger technique (LC) in acute hospitalized patients with difficult venous access.
  
  
  METHODS
  This was a prospective, randomized controlled trial. A total of 100 consecutively admitted subjects in an urban High Dependency Unit were randomized to obtain US-guided intravenous access using either SC or LC after 3 failed blind attempts. Primary outcome was catheter failure rate.
  
  
  RESULTS
  Success rate was 86% in the SC groups and 84% in the LC group (P=.77). Time requested to positioning venous access resulted to be shorter for SC as opposed to LC (9.5 vs 16.8 minutes, respectively; P=.001). Catheter failure was observed in 45% of patients in the SC group and in 14% of patients in the LC group (relative risk, 3.2; P<.001).
  
  
  CONCLUSIONS
  Both SC and LC US-guided cannulations have a high success rate in patients with difficult venous access. Notwithstanding a higher time to cannulation, LC US-guided procedure is associated with a lower risk of catheter failure compared with SC US-guided procedure.
authors.affiliation: High Dependency Unit, San Giovanni Bosco Hospital, Piazza Donatore del Sangue 3, 10154 Torino, Italy. fabrizioelia@yahoo.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Elia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ferrari
authors.forename: Paola
authors.initials: P
authors.lastname: Molino
authors.forename: Marcella
authors.initials: M
authors.lastname: Converso
authors.forename: Giovanna
authors.initials: G
authors.lastname: De Filippi
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.forename: Franco
authors.initials: F
authors.lastname: Aprà
mesh_terms: D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects; D003422:Critical Care / Q000379:methods; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods