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International Journal of Emergency Medicine

, 4:53

First Online: 25 August 2011Received: 28 June 2011Accepted: 25 August 2011

Abstract

BackgroundStudies have shown that vein size is an important predictor of successful ultrasound-guided vascular access. The objective of this study is to evaluate maneuvers designed to increase basilic vein size, which could be used to facilitate ultrasound-guided peripheral intravenous access USGPIV in the Emergency Department ED setting.

MethodsThis was a prospective non-randomized trial. Healthy volunteers aged 18-65 were enrolled. Basilic veins were identified and the cross-sectional area measured sonographically. Following baseline measurement, the following maneuvers were performed: application of a tourniquet, inflation of a blood pressure BP cuff, application of a tourniquet with the arm lowered, and BP cuff inflation with the arm lowered. Following each maneuver there was 30 s of recovery time, and a baseline measurement was repeated to ensure that the vein had returned to baseline. Change in basilic vein size was modeled using mixed model analysis with a Tukey correction for multiple comparisons to determine if significant differences existed between different maneuvers.

ResultsOver the 5-month study period, 96 basilic veins were assessed from 52 volunteers. All of the maneuvers resulted in a statistically significant increase in basilic vein size from baseline p < 0.001. BP cuff inflation had the greatest increase in vein size from baseline 17%, 0.87 mm 95% CI 0.70-1.04. BP cuff inflation statistically significantly increased vein size compared to tourniquet placement by 3%, 0.16 mm 95% CI 0.02-0.30.

ConclusionsThe largest increase in basilic vein size was due to blood pressure cuff inflation. BP cuff inflation resulted in a statistically significant increase in vein size compared to tourniquet application, but this difference may not be clinically significant.

Electronic supplementary materialThe online version of this article doi:10.1186-1865-1380-4-53 contains supplementary material, which is available to authorized users.

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Autor: Simon A Mahler - Greta Massey - Liliana Meskill - Hao Wang - Thomas C Arnold

Fuente: https://link.springer.com/article/10.1186/1865-1380-4-53



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