Ultrasound-Guided Long Peripheral Catheters for Venous Access in the Intensive Care Unit: A Descriptive Study.

Background: Central venous catheters (CVCs) are the choice of venous access if patients require vasoactive drugs or multiple infusions but are not free of adverse effects. They should be removed when deemed unnecessary. In cases of difficult venous access, long peripheral catheters (LPCs) placed in the bigger veins of the arm under sonographic guidance are a good option. Therefore, we conducted this study to evaluate their usefulness.

Methods: This prospective descriptive study evaluated LPCs for venous access placed under ultrasound guidance in one of the three major veins of the upper extremity, namely the basilic, brachial, and cephalic veins. For this purpose, we used the LeaderCath™ (Vygon, Paris, FRA).

Results: This descriptive study included 38 patients with LPCs. Difficult peripheral venous access was the most common indication for LPC placement (44.7%). The second most common reason was removing old CVCs from patients requiring frequent sampling (31.6%). The median duration of the procedure was three minutes (IQR: 1.5 to 10 minutes). The median dwell time for LPC was eight days (IQR: five to 11 days, maximum 30 days). Twenty-six (68.4%) patients had good backflow until removal, which served as a channel for aspirating blood for sampling. Patients with LPCs had better comfort scores than those with CVC (8 (6, 8) vs. 5 (5, 6); p = 0.008).

Conclusion: To secure peripheral venous access under sonographic guidance, LPCs would provide additional advantages such as a channel for backflow and sampling and longer dwell time compared to conventional peripheral intravenous cannulas.