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Peripheral venous catheterization is a fundamental part of the management of critically-ill patients, especially for administration of intravenous emergency treatments. In general, it is preferred to central catheterization whenever possible, since it is less invasive, achievable immediately by the nurse, and responsible for fewer complications.
Venous access difficulties are frequent in critically-ill patients. Among tools proposed to improve the practice of peripheral catheterization, ultrasound and infrared illumination are the most studied, the latter being simpler. Infrared illumination has never been evaluated in intensive care. However, the delay or failure of peripheral catheterization is highly detrimental in the context of resuscitation as it may delay or impede appropriate management of vital emergencies. Our study will focus on the peripheral venous catheterization of the upper limbs, as these are the reference site for this technique The objective is to evaluate the interest of infrared illumination (AccuVein AV500®) for the primary success (first puncture) of peripheral venous catheterization of the upper limbs in patients with resuscitation at risk of catheterization venous difficult.
It is a comparative, superiority, prospective, multicenter, randomized, controlled, open-label, phase III trial. Subjects will be divided into two groups with a 1: 1 ratio. Nurses at participating centers will be trained for the use of the device prior to the start of the study; the use of the device is singularly easy and intuitive.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Infrared illumination group | Experimental | The nurse uses the Accuvein® device to identify the veins before puncture. |
|
| Control group | No Intervention | The nurse proceeds as usual (visual identification in the light of the room and palpation) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ACCUVEIN | Device | The nurse uses the Accuvein® device to identify the veins before puncture and then proceeds as usual, under illumination of the device. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of primary success of peripheral venous catheterization in the upper limbs. | success defined as the need of a single puncture for the effective catheterization. The effective catheterization is confirmed by obtaining venous reflux by declivity of the infusion bag. | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of punctures required for peripheral venous catheterization. | Day 1 | |
| Rate of failure of the procedure, defined by the absence of placement of a peripheral venous catheter before the end of the procedure | Day 1 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fabien BOUSSELY, senior officer | Contact | 01 49 81 42 50 | 33 | fabien.boussely@aphp.fr |
| Akim SOUAG | Contact | (0)1 44 84 17 15 | 33 | akim.souag@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Fabien BOUSSELY, senior officer | Assistance publique des hopitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Henri-Mondor Hospital | Recruiting | Créteil | Val De Marne | 94000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23353941 | Background | Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb;41(2):580-637. doi: 10.1097/CCM.0b013e31827e83af. | |
| 27100437 |
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DATAS ARE OWN BY ASSISTANCE PUBLIQUE - HOPITAUX DE PARIS, PLEASE CONTACT SPONSOR FOR FURTHER INFORMATION
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Subjects will be divided into two groups with a 1: 1 ratio. Each patient will be assigned to one of the following 2 arms:
- Usual technique : Visualization of the vein to be catheterized will be done directly. without infrared illumination.
or
-Use of the Accuvein® device: Visualization of the vein to be catheterized will be done with infrared illumination.
In both groups, catheterization will be carried out according to the usual technique in accordance with the recommendations.
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| Background |
| Loon FHJV, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA Scale: A Clinical Predictive Scale to Identify Difficult Intravenous Access in Adult Patients Based on Clinical Observations. Medicine (Baltimore). 2016 Apr;95(16):e3428. doi: 10.1097/MD.0000000000003428. |
| 39915026 | Derived | Ouedraogo R, Alves A, Bruant A, Sy O, Tabra Osorio C, Schortgen F, Chenal A, Contou D, Krzyzaniak L, Fartoukh M, Le Joncour M, Mongardon N, Ait Benaissa L, Da Silva D, Bouguerra M, Demeret S, Tanguy Dubois S, Starczala E, Petyt C, Schmidt M, Dezellus S, Georger JF, Pallud AC, Carras D, Boussely F, Audureau E, Mekontso Dessap A. Infrared illumination for difficult peripheral venous catheterisation in critically ill adult patients: the prospective, randomised, multicentre ICARE trial. BMJ Open. 2025 Feb 6;15(2):e090611. doi: 10.1136/bmjopen-2024-090611. |