title: Ultrasound-guided deep-arm veins insertion of long peripheral catheters in patients with difficult venous access after cardiac surgery.
abstract: OBJECTIVE
  To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance.
  
  
  BACKGROUND
  In difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters.
  
  
  METHODS
  Prospective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed.
  
  
  RESULTS
  A 100% placement success rate was documented. The catheter dwell-time was 14.7 ± 11.1 days. Most catheters were removed at end-use in the absence of complications. The rate of catheters appropriately or inappropriately removed before completing the intravenous therapies was 27.7/1000 catheter-days. Two thrombophlebitis (1.91/1000 catheter-days) and 1 catheter-related bloodstream infection (0.96/1000 catheter-days) occurred.
  
  
  CONCLUSIONS
  L-PVC could be a viable solution in DVA patients, as it may reduce the need for multiple vein punctures, patients' discomfort, and nursing workload. A better adherence to catheter management recommendations should further reduce complications.
authors: Cardiac Surgery Intensive Care Unit, Azienda Sanitaria Universitaria Integrata, Strada di Fiume 447, 34148, Trieste, Italy.
authors: Adam
authors: A
authors: Fabiani
authors: Cardiac Surgery Intensive Care Unit, Azienda Sanitaria Universitaria Integrata, Strada di Fiume 447, 34148, Trieste, Italy.
authors: Lorella
authors: L
authors: Dreas
authors: School of Nursing, University of Trieste, Piazzale Valmaura 9, 34147, Trieste, Italy; Azienda Sanitaria Universitaria Integrata, Strada di Fiume 447, 34148, Trieste, Italy. Electronic address: gsanson@units.it.
authors: Gianfranco
authors: G
authors: Sanson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D006348:Cardiac Surgical Procedures; D002406:Catheterization, Peripheral / Q000379:methods*; D057785:Catheters; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*; D014680:Veins / Q000000981:diagnostic imaging*
keywords: Complications; Difficult venous access; Nursing; Peripheral venous catheterization; Ultrasonography