Matsumoto Miharu, Tateishi Ayami, Kobayashi Hiromitsu, Hashiguchi Nobuko
Department of Health Sciences, Kyushu University, Fukuoka, Japan.
Department of Health Sciences, Graduate school of Medical sciences, Kyushu University, Fukuoka, Japan.
PLoS One. 2025 May 9;20(5):e0323367. doi: 10.1371/journal.pone.0323367. eCollection 2025.
The difficulty of venipuncture depends on the visibility and palpability of the vein and is particularly challenging in older adults, patients with abnormal body mass index, and those with chronic diseases. In these populations, vessel fibrosis, scarring, skin atrophy, and subcutaneous fat reduce vein visibility and palpability, making venous access more challenging. Previous studies have shown that visibility and palpability are associated with vein depth and diameter, respectively. The current study therefore aimed to evaluate the validity of vein depth and vein diameter as predictive indicators of vein visibility and palpability during venipuncture.
Three nurses evaluated the visibility and palpability of superficial veins suitable for venipuncture in 96 healthy volunteers who participated in this study. Using ultrasound imaging devices, the depth and diameter of superficial veins were measured, after which receiver operating characteristic (ROC) curves were created to identify the optimal cutoff values for predicting vein visibility and palpability.
Both vein depth and diameter were found to be independent predictors of visibility and palpability (p < 0.05). ROC analysis showed that vein depth was a significant predictor of visibility (AUC = 0.901, 95% CI = 0.834-0.967) and palpability (AUC = 0.724, 95% CI = 0.619-0.829). The optimal cutoff values for vein depth were 1.89 mm for visibility discrimination, with 28.1% of veins exceeding this threshold, and 1.44 mm for palpability, with 59.4% of veins exceeding this threshold. On the other hand, vein diameter was less accurate than vein depth in predicting visibility and palpability (AUC < 0.7).
Vein depth is an effective predictor of vein visibility and vein palpability. This finding is expected to inform the development of assistive technology for visual and palpatory examinations.
静脉穿刺的难度取决于静脉的可视性和可触知性,在老年人、身体质量指数异常的患者以及患有慢性疾病的患者中尤其具有挑战性。在这些人群中,血管纤维化、瘢痕形成、皮肤萎缩和皮下脂肪会降低静脉的可视性和可触知性,使静脉通路的建立更具挑战性。先前的研究表明,可视性和可触知性分别与静脉深度和直径相关。因此,本研究旨在评估静脉深度和静脉直径作为静脉穿刺时静脉可视性和可触知性预测指标的有效性。
三名护士对参与本研究的96名健康志愿者中适合静脉穿刺的浅表静脉的可视性和可触知性进行了评估。使用超声成像设备测量浅表静脉的深度和直径,之后绘制受试者工作特征(ROC)曲线以确定预测静脉可视性和可触知性的最佳截断值。
发现静脉深度和直径均为可视性和可触知性的独立预测因素(p < 0.05)。ROC分析表明,静脉深度是可视性(AUC = 0.901,95%CI = 0.834 - 0.967)和可触知性(AUC = 0.724,95%CI = 0.619 - 0.829)的显著预测因素。静脉深度的最佳截断值在区分可视性时为1.89毫米,超过该阈值的静脉占28.1%,在区分可触知性时为1.44毫米,超过该阈值的静脉占59.4%。另一方面,静脉直径在预测可视性和可触知性方面不如静脉深度准确(AUC < 0.7)。
静脉深度是静脉可视性和静脉可触知性的有效预测因素。这一发现有望为视觉和触诊检查辅助技术的开发提供参考。