title: Difficult peripheral venous access: clinical evaluation of a catheter inserted with the Seldinger method under ultrasound guidance.
abstract: OBJECTIVE
  A preliminary observational study was undertaken to evaluate the risk of failure of ultrasound-guided peripheral intravenous catheterization of a deep arm vein for a maximum of 7 days, after peripheral intravenous (PIV) cannulation failure.
  
  
  METHODS
  This prospective study included patients referred to the intensive care unit for placement of a central line, a polyurethane cannula commercialized for arterial catheterization was used for peripheral venous cannulation. Catheter length and diameter were chosen based on preliminary ultrasound measurements of vein diameter and skin-vein distance.
  
  
  RESULTS
  Catheterization was successful for all 29 patients. Mean vein diameter was 0.42 ± 0.39 cm; mean vein depth was 0.94 ± 0.52 cm. Mean catheter duration was 6 (median 7) days. Two occluded catheters were removed prematurely. No thrombophlebitis, catheter infection, or extravasation was observed.
  
  
  CONCLUSIONS
  Our results suggest that catheters inserted with the Seldinger method are adapted to prolonged peripheral deep-vein infusion. Ultrasound can play a role in catheter monitoring by identifying early thrombosis formation.
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France. Electronic address: pascalmeyer@voila.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Meyer
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Cronier
authors.affiliation: Clinical Research Unit, Hôpital Lariboisière, 75010 Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Rousseau
authors.affiliation: Clinical Research Unit, Hôpital Lariboisière, 75010 Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vicaut
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Choukroun
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Chergui
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chevrel
authors.affiliation: Intensive Care Unit, Hôpital St-Antoine, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Maury
mesh_terms: D000368:Aged; D001132:Arm; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D057785:Catheters / Q000592:standards; D002408:Catheters, Indwelling / Q000592:standards; D004867:Equipment Design; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D018084:Ultrasonography, Interventional; D014680:Veins / Q000033:anatomy & histology
keywords: Difficult venous access; Peripheral venous access; Seldinger technique; Ultrasound guidance