IV Catheter Placement for Cancer Emergencies

Overseen By Jonathan Rowland, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: M.D. Anderson Cancer Center

Disqualifiers: Pregnancy, Non-English speakers, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 10 days

400 Participants Needed

Trial Summary

What is the purpose of this trial?

To learn about the effects of the length of the catheter on the failure and success rate of USIV placement.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Ultrasound-guided Peripheral Intravenous Catheter Placement?

Research shows that using ultrasound guidance for placing IV catheters can lead to higher success rates and fewer attempts, especially in patients with difficult IV access. It also reduces the need for more invasive procedures like central venous catheters, which can improve patient satisfaction and reduce costs. ^{1 2 3 4 5}

How is the treatment Ultrasound-guided Peripheral Intravenous Catheter Placement different from other treatments for cancer emergencies?

Ultrasound-guided Peripheral Intravenous Catheter Placement is unique because it uses ultrasound technology to help place IV catheters more accurately, especially in patients with difficult-to-access veins. This method can reduce the need for more invasive central venous catheters, leading to quicker treatment, lower costs, and higher patient satisfaction. ^{2 3 4 6 7}

Research Team

Jonathan Rowland, MD

Principal Investigator

M.D. Anderson Cancer Center

Eligibility Criteria

This trial is for adults over 18 who need an IV placed due to hard-to-find veins and are expected to stay in the hospital for more than 48 hours. It's not for those likely to leave soon, unable to consent, pregnant women, or non-English speakers.

Inclusion Criteria

I need ultrasound-guided IV due to hard-to-find veins.

I am expected to be admitted to the hospital for more than 48 hours.

Provision of signed and dated informed consent form

Exclusion Criteria

Expected/anticipated discharge disposition from the ACCC (per discussion with treating physician)

Pregnant women

I am unable to understand and agree to the study's details.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive ultrasound-guided peripheral intravenous catheter placement with varying catheter lengths

10 days

Follow-up

Participants are monitored for safety and effectiveness after treatment, including adverse events and catheter failure

Up to 1 year

Treatment Details

Interventions

• Ultrasound-guided Peripheral Intravenous Catheter Placement

Trial Overview The study is testing if different lengths of a specific IV catheter (Introcan Safety) affect how well it works when guided by ultrasound in patients with cancer-related emergencies.

Participant Groups

Group I: Group B Experimental Treatment 1 Intervention

Participants will receive a catheter that is either 1.75 or 2.5 inches long based on what the nurse thinks is best for you.

Group II: Group A Experimental Treatment 1 Intervention

Participants will receive a catheter that is up to 1.75 inches long based on what the nurse thinks is best for you.

Ultrasound-guided Peripheral Intravenous Catheter Placement is already approved in United States, Canada, European Union for the following indications:

Approved in United States as USGPIV for:

• Difficult peripheral IV access
• Emergency department use
• Oncologic emergency department use

Approved in Canada as USGIVC for:

• Peripheral IV access in challenging cases
• Emergency department use

Approved in European Union as Ultrasound-guided Peripheral IV for:

• Difficult peripheral IV access
• Emergency department use
• General medical use

Who Is Running the Clinical Trial?

M.D. Anderson Cancer Center

Lead Sponsor

Trials

3,107

Recruited

1,813,000+

Findings from Research

A study involving 43,470 peripheral intravenous catheters showed that ultrasound-guided peripheral intravenous catheter (USGPIV) insertions had significantly lower failure rates compared to traditional landmark peripheral intravenous catheters (PIVs) after 30 days.

The training program for nurses using simulation-based mastery led to improved survival rates for USGPIVs in patients with difficult intravenous access, indicating that this method is more effective than standard PIVs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Performance of peripheral catheters inserted with ultrasound guidance versus landmark technique after a simulation-based mastery learning intervention. Feinsmith, SE., Amick, AE., Feinglass, JM., et al.[2023]

After a 2-hour training session, pediatric nurses achieved a 70% success rate in placing ultrasound-guided peripheral intravenous catheters (USGPIV) in children, indicating that the training was effective.

It was found that nurses needed to perform about nine attempts after training to reach a 70% probability of success on their next attempt, highlighting the importance of practice in developing competence with this technique.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound guided peripheral IV placement: An observational study of the learning curve in pediatric patients. Anderson, AP., Taroc, AM., Wang, X., et al.[2022]

In a study of 100 patients with difficult IV access, ultrasound-guided peripheral IV catheters (USGPIVs) successfully prevented the need for central venous catheters (CVCs) in 85% of cases, highlighting their efficacy in emergency settings.

The overall complication rate for patients who did require CVC placement was low, with only 1 out of 15 patients developing a catheter-related infection, suggesting that USGPIVs can reduce the risks associated with CVCs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. Au, AK., Rotte, MJ., Grzybowski, RJ., et al.[2022]

A specialized training program for 12 NICU nurses on ultrasound-guided intravenous (USGIV) access resulted in a significant 25% increase in knowledge and improved confidence in performing the technique.

All trained nurses successfully demonstrated proficiency in USGIV access, achieving at least 80% success in simulated attempts, indicating that USGIV can be effectively employed in neonatal patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Standardized Training Program in Ultrasound-Guided Intravenous Line Placement: Improving Nurses' Confidence and Success. McKinney, A., Steanson, K., Lebar, K.[2023]

The modified Seldinger technique for ultrasound-guided peripheral intravenous access (USGPIV) demonstrated a high success rate of 96% in a study of 25 patients with difficult IV access.

This technique resulted in a mean of only 1.32 needle sticks and a median catheter insertion time of 68 seconds, indicating it is both efficient and effective for patients who have had multiple failed attempts at IV access.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound-guided peripheral intravenous access in the emergency department using a modified Seldinger technique. Mahler, SA., Wang, H., Lester, C., et al.[2014]

A training program for emergency nurses on ultrasound-guided peripheral intravenous (PIV) catheter placement was developed, resulting in 92.9% of participants feeling adequately prepared for the procedure.

After training, 100% of nurses believed it was feasible to train others in this technique, and 71.4% strongly supported the continuation of the training program, indicating a high level of confidence and competence in performing ultrasound-guided PIV placements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses. Edwards, C., Jones, J.[2020]

Ultrasound-guided peripheral intravenous catheter placement can significantly improve patient satisfaction and reduce the need for central catheters, making it a valuable technique for nurses in acute care settings.

Despite its benefits, the adoption of this technique among critical and acute care nurses has been slow, highlighting the need for increased training and encouragement to utilize ultrasound guidance for difficult venous access.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound-Guided Peripheral Intravenous Catheter Insertion: The Nurse's Manual. Morata, L., Bowers, M.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Performance of peripheral catheters inserted with ultrasound guidance versus landmark technique after a simulation-based mastery learning intervention. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Ultrasound guided peripheral IV placement: An observational study of the learning curve in pediatric patients. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

A Standardized Training Program in Ultrasound-Guided Intravenous Line Placement: Improving Nurses' Confidence and Success. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Ultrasound-guided peripheral intravenous access in the emergency department using a modified Seldinger technique. [2014]

6. United States pubmed.ncbi.nlm.nih.gov

Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Ultrasound-Guided Peripheral Intravenous Catheter Insertion: The Nurse's Manual. [2021]