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The aim of this study is to perform a comparative analysis of clinical outcomes associated with the use of an ultra-long peripheral catheter using (catheter-over-the-needle technique) versus an AST-long peripheral catheter in adult patients with difficult intravenous access (DIVA) in a real-world clinical setting. Specifically, the study will assess potential benefits, including longer mean catheter dwell time and improved catheter usability, as well as potential harms, such as increased incidence of catheter-related thrombosis, infections, phlebitis, infiltration, and unplanned catheter removal.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Accelerated seldinger technique LPC | Active Comparator | One study arm will be assigned the AST-long peripheral catheter (Powerglide Pro long peripheral catheter, BD) available in 18G 100 mm, 20G 100 mm (approx. 3.94 inches) and 22G 80 mm (approx. 3.15 inches). |
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| Ultra-long peripheral catheter | Experimental | The other study arm will be assigned the ultralong peripheral catheter (Introcan Safety deep access catheter, B. Braun) available in 18, 20 and 22G and 63.5 mm (approx. 2.5 inches) in length. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Powerglide pro™ | Device | A long peripheral catheter will be placed under ultrasound guidance. This catheter will be placed by using the Accelerated seldinger technique. |
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| Measure | Description | Time Frame |
|---|---|---|
| Dwell time | is defined as the duration between the date of catheter insertion and the date of its removal, expressed in hours. | Until study completion, an average of 14 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Catheter related thrombosis | CRT indicates the presence of clots in the vascular system after the placement of a catheter due to induced trauma to the endothelium, inflammation, individual patient factors and catheter related factors. The following types of thrombi will be reported.
| Until study completion, an average of 14 days. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitair ziekenhuis Brussel | Brussels | Jette | 1090 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41651529 | Derived | Pieteraerens W, Vanhonacker D, Beeckman K, Torsy T. Ultra long peripheral catheter versus accelerated Seldinger technique long peripheral catheter in difficult intravenous access patients (ULAST): a pragmatic randomised controlled trial protocol. BMJ Open. 2026 Feb 6;16(2):e106079. doi: 10.1136/bmjopen-2025-106079. |
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The data is confidential.
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| Introcan safety deep access | Device | The catheter will be placed using ultrasound guidance and by using the 'catheter-over-the needle' approach. |
|
| Number of Participants with Midline catheter related infections | MLABSI are defined as laboratory confirmed bloodstream infections in patients who had a midline catheter in place for two or more calendar days prior to confirmation. MLABSI will be diagnosed as:
These parameters will be combined to report MLABSI. | Until study completion, an average of 14 days. |
| Number of Participants with Phlebitis | Phlebitis will be defined as the inflammation of a vein resulting from mechanical, chemical, or bacterial causes. The severity of this inflammation will be assessed using the Visual Infusion Phlebitis (VIP) scale, which assigns a score ranging from 0 to 5, with 0 indicating a healthy insertion site. A score of 5 on the VIP scale signifies severe pain, redness, palpable venous cord, and fever-related complaints. A score of 2, indicating pain, erythema and swelling, necessitates immediate catheter relocation. Symptomatic catheter-related thrombosis must be excluded in advance. | Until study completion, an average of 14 days. |
| Number of Participants with Loss of catheter usability | Loss of catheter usability will be registered by using the following categories38: Total occlusion: inability to infuse and aspirate Sub-occlusion: Difficulty in infusing and aspirating Persistent withdrawal occlusion: No blood withdrawal possibility | Until study completion, an average of 14 days. |
| Number of Participants with Unplanned removal | Removal of an uncomplicated catheter without therapy completion (accidental removal, patient death) | Until study completion, an average of 14 days. |