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Peripheral venous catheterization represents the preferential option for term or preterm infant care in order to start drug treatment or hydration, or perform anesthesia.
However, the peripheral venous access is associated in approximately 50% of cases with a failure of the insertion on the first attempt in an emergency context. Using a micro-guide may facilitate the peripheral venous catheterization in newborns, by guiding the catheter in the vein and, thereby reduce the risk of transfixion of the vascular lumen.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Insertion of peripheral venous catheter with micro-guide | Experimental |
| |
| Classic insertion of peripheral venous catheter, without micro-guide | Other |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Insertion of peripheral venous catheter with micro-guide | Device | After antisepsis, the vein is punctured using a needle. Then the micro-guide is inserted to the first landmark, which indicates the passage of the micro-guide beyond the end of the needle. After the needle removed, the peripheral venous catheter is placed on the micro-guide. The guide is then removed, the peripheral venous catheter can be used. |
| Measure | Description | Time Frame |
|---|---|---|
| Success of peripheral venous catheterization at the first attempt | The success of the placement is defined by the arrival of blood in the transparent chamber downstream of the needle during the placement, and by the absence of painful reaction and edema near the insertion site, indicating extravasation or extravascular passage, after flushing the catheter with 0.5 to 1 ml of isotonic saline. The success will be confirmed by retesting flush after securing the peripheral venous catheter in a dressing, within 3 to 5 minutes of successful puncture. | Up to 5 minutes after the success of the placement |
| Measure | Description | Time Frame |
|---|---|---|
| Efficiency of the technique | Assessed by the number of venipuncture attempts. | Up to 4 days. |
| Efficiency of the technique | Assessed by the duration of the installation (time from the end of skin asepsis to the end of the occlusive dressing). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gilles CAMBONIE | Contact | 04 67 33 65 56 | g-cambonie@chu-montpellier.fr | |
| Vincent BRODEAU | Contact | 04 67 33 66 09 | v-brodeau@chu-montpellier.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Montpellier | Recruiting | Montpellier | 34295 | France |
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Peripheral venous catheterization is perform by a nurse. The placement characteristics are evaluated by the investigator, blind of the condition of placement if possible.
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| Classic insertion of peripheral venous catheter, without micro-guide | Other | After antisepsis, the catheter is introduced into the vein by a needle which is subsequently removed while the catheter remains in place. |
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| Up to 4 days. |
| Efficiency of the technique | Assessed by the requirement to insert a central venous line directly linked to failure of peripheral venous catheterization. | Up to 4 days. |
| Efficiency of the technique | Assessed by the reason for removal of peripheral venous catheter (ie, elective removal or removal for the occurrence of adverse events, see below). | Up to 4 days. |
| Adverse events | Specifically associated with the micro-guide: section, intravascular migration, venous transfixion. | Up to 4 days. |
| Adverse events | Common to the placement of any peripheral venous catheter, regardless of the insertion technique : puncture of an artery, pain, hemorrhage at the puncture site, phlebitis, thrombosis, infection, obstruction and subcutaneous diffusion of the infusion. | Up to 1 month. |