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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how catheter length affects the success of IV placement using ultrasound guidance (Ultrasound-guided Peripheral Intravenous Catheter Placement). Participants will receive either a shorter catheter (up to 1.75 inches) or a slightly longer one (1.75 or 2.5 inches), based on the nurse's recommendation. The trial aims to determine which length is more effective for individuals who have difficulty with IV placement. Candidates include those who frequently experience IV placement challenges and are expected to stay in the hospital for more than 48 hours. As an unphased trial, this study allows participants to contribute to improving IV placement techniques for those with difficult access.

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 prior data suggests that this method is safe for IV catheter placement in cancer emergencies?

Research has shown that using ultrasound to guide the placement of a peripheral intravenous (IV) catheter is generally safe and well-tolerated. This method can be safer and quicker than the traditional approach, helping nurses insert IVs more effectively, which is crucial for patients needing fast treatment.

For example, one study found that this technique succeeded in many catheter placements, demonstrating its reliability. Another study noted its particular benefit for cancer patients requiring long-term therapy, as it helps protect their veins. Overall, these findings suggest that the ultrasound-guided method is a good choice for placing catheters, with minimal risk of side effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using ultrasound-guided peripheral intravenous catheter placement in cancer emergencies because it offers a more precise and potentially quicker method for placing IV catheters. Traditional methods rely on feeling for veins and can be challenging, especially in patients with difficult vein access. This ultrasound-guided technique allows for real-time visualization of veins, making it easier to place the catheter correctly on the first attempt, which can be crucial in emergency situations. This approach not only aims to improve patient comfort but also reduces the time and complications associated with repeated attempts in catheter placement.

What evidence suggests that this method is effective for IV catheter placement in cancer emergencies?

Research has shown that using ultrasound to guide IV catheter placement is highly effective. One study found a first-try success rate of 85.7%, significantly better than traditional methods. Another study demonstrated that ultrasound improved first-try success to 84.3%, compared to just 51.0% with the usual technique. This method is also generally faster, reducing the average time needed to place the IV successfully. In this trial, participants in Group A will receive a catheter up to 1.75 inches long, while those in Group B will receive a catheter either 1.75 or 2.5 inches long, based on the nurse's judgment. This evidence suggests that using ultrasound can greatly enhance the success of IV catheter placement, which is especially important for patients undergoing cancer treatment. ^{2 3 4 5 6}

Who Is on the Research Team?

Jonathan Rowland, MD

Principal Investigator

M.D. Anderson Cancer Center

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12566756/

Recent Advances in Ultrasound-Guided Peripheral ... This trial reported a first-time insertion success rate of 85.7% for ultrasound-guided peripheral IV catheter insertion, a significant improvement compared to ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07208175

Effectiveness of Ultrasound-Guided Versus Traditional IV ... Given the vulnerability of cancer patients and the importance of vein preservation for long-term therapy, this study investigates whether USG ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S2405844024066131

The ultrasound-guided versus standard technique for ... Regarding the time for completing a successful insertion, the results of average ranged from 74 to 3612 s in USGPIVC group and from 170 to 10359 ...

4. journals.lww.com journals.lww.com/md-journal/fulltext/2025/10100/a_retrospective_cohort_study_on_the_use_of.135.aspx

A retrospective cohort study on the use of ultrasound in... Compared to the traditional group, the ultrasound-guided group exhibited a marked improvement in first-attempt success (84.3% vs 51.0%, P <.001) ...

5. journals.sagepub.com journals.sagepub.com/doi/10.1177/11297298251389647

Ultrasound-guided peripheral intravenous catheter ... This retrospective study analyzed a 10-year dataset of 29,436 ultrasound-guided peripheral IV insertions performed by 14 vascular access ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10204754/

Outcomes of Ultrasound Guided Peripheral Intravenous ... Of these, three RNs were responsible for 72.9% (906/1357) of the total catheter placement attempts and 73.1% (674/980) of the successful ...