Department of Technical and Anesthesia Nursing Sciences, Fontys University of Applied Sciences, Eindhoven, The Netherlands.
Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands.
J Vasc Access. 2022 Mar;23(2):295-303. doi: 10.1177/1129729821990217. Epub 2021 Feb 2.
Peripheral intravenous cannulation is the preferred method to obtain vascular access, but not always successful on the first attempt. Evidence on the impact of the intravenous catheter itself on the success rate is lacking. Faster visualization of blood flashback into the catheter, as a result of a notched needle, is thought to increase first attempt success rate. The current study aimed to assess if inserting a notched peripheral intravenous catheter will increase first attempt cannulation success up to 90%, when compared to inserting a catheter without a notched needle.
In this block-randomized trial, adult patients in the intervention group got a notched peripheral intravenous catheter inserted, patients in the control group received a traditional non-notched catheter. The primary objective was the first attempt success rate of peripheral intravenous cannulation. Intravenous cannulation was performed according to practice guidelines and hospital policy.
About 328 patients were included in the intervention group and 330 patients in the control group. First attempt success was 85% and 79% for the intervention and control group respectively. First attempt success was remarkably higher in the intervention group regarding patients with a high risk for failed cannulation (29%), when compared to the control group (10%).
This study was unable to reach a first attempt success of 90%, although first attempt cannulation success was higher in patients who got a notched needle inserted when compared to those who got a non-notched needle inserted, unless a patients individual risk profile for a difficult intravenous access.
外周静脉置管是获得血管通路的首选方法，但并非首次尝试就能成功。目前尚缺乏有关静脉导管本身对成功率影响的证据。有研究认为，带侧孔的针头可使血液更快地回流到导管中，从而提高首次尝试的成功率。本研究旨在评估与使用无侧孔的外周静脉导管相比，使用带侧孔的外周静脉导管是否能将首次尝试置管的成功率提高至 90%。
本研究为单盲、随机对照试验，干预组患者使用带侧孔的外周静脉导管，对照组患者使用传统的无侧孔导管。主要观察指标为外周静脉置管的首次尝试成功率。静脉置管操作均按照实践指南和医院政策进行。
干预组和对照组分别纳入 328 例和 330 例患者。干预组和对照组的首次尝试成功率分别为 85%和 79%。对于有较高置管失败风险（29%）的患者，干预组的首次尝试成功率显著高于对照组（10%）。
尽管与使用无侧孔针头的患者相比，使用带侧孔针头的患者首次尝试置管的成功率更高，但本研究未能达到 90%的首次尝试成功率，除非患者个人的静脉穿刺难度风险特征。
