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In adult patients, ultrasound-guided long catheter IVs for difficult venous access have been shown to provide increased duration of use, reduced complication rates, and greater cost-effectiveness.
However, there are relatively few studies examining the use of ultrasound for IV access in pediatric patients.
A recent study, the DIAPEDUS study, investigated the success rate of peripheral IV access with and without ultrasound assistance in pediatric patients with difficult venous access.
The study included 110 pediatric patients. IVs were placed by 25 nurses and 6 pediatricians, each of whom had completed departmental training involving at least 20 ultrasound-guided IV placements prior to the study.
The results showed a significantly higher success rate on the first attempt with ultrasound-guided techniques (90% vs. 18%), along with reduced procedural time and fewer attempts overall.
Bottom Line: For patients with known difficult venous access, ultrasound-guided IV placement should be the first-line approach.
References
D'Alessandro M, Ricci M, Bellini T, Chianucci B, Calevo MG, Piccotti E, Moscatelli A. Difficult Intravascular Access in Pediatric Emergency Department: The Ultrasound-Assisted Strategy (DIAPEDUS Study). J Intensive Care Med. 2024 Mar;39(3):217-221. doi: 10.1177/08850666231199050
Bahl A, Johnson S, Hijazi M, Mielke N, Chen NW. Cost effectiveness of ultrasound-guided long peripheral catheters in difficult vascular access patients. J Vasc Access. 2024 Jul;25(4):1204-1211. doi: 10.1177/11297298231154297.