RESUMO
BACKGROUND: Peripheral intravenous cannulation is one of the most common invasive procedures for hospitalised patients. Patients with difficult venous access require special measures to facilitate cannulation. Veinplicity applies mild electrical stimulation to forearm veins to aid vessel dilation. To assess this new technique, we compared its effect on the veins to that of standard heat treatment. METHODS: In all, 20 volunteers were randomised to receive either application of heat packs to the forearm and later stimulation with Veinplicity or the same two treatments in reverse order. Ultrasound measurements of the basilic, cephalic and brachial veins were taken at intervals during and after treatment and compared with baseline values. RESULTS: The mean maximum vein diameter increase from baseline was significantly higher with Veinplicity than with heat packs (49.94% ± 23.55% vs 36.26% ± 23.09%, p = 0.021). In addition, the mean duration of the dilatory effect was significantly longer with Veinplicity than with heat packs (9.7 ± 3.9°min vs 4.9 ± 2.2°min, p < 0.001). CONCLUSION: Veinplicity dilates forearm veins more effectively and for a longer time than commonly used heat packs. This new treatment option appears to be a valuable addition to the vascular access toolkit, with the potential to improve first-attempt cannulation rates and spare patients from discomfort, pain and iatrogenic vessel trauma.
Assuntos
Cateterismo Periférico/métodos , Terapia por Estimulação Elétrica , Antebraço/irrigação sanguínea , Hipertermia Induzida , Vasodilatação , Veias , Adulto , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/instrumentação , Estudos Cross-Over , Terapia por Estimulação Elétrica/efeitos adversos , Terapia por Estimulação Elétrica/instrumentação , Inglaterra , Feminino , Humanos , Hipertermia Induzida/efeitos adversos , Hipertermia Induzida/instrumentação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Punções , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia , Veias/diagnóstico por imagem , Adulto JovemRESUMO
INTRODUCTION: Ovarian cancer is the leading cause of death from gynaecological cancer, with more than 7000 new cases registered in the UK in 2014. In patients suitable for surgery, the National Institute of Health and Care Excellence guidance for treatment recommends surgical resection of all macroscopic tumour, followed by chemotherapy. The surgical procedure can be extensive and associated with substantial blood loss which is conventionally replaced with a donor blood transfusion. While often necessary and lifesaving, the use of donor blood is associated with increased risks of complications and adverse surgical outcomes. Intraoperative cell salvage (ICS) is a blood conservation strategy in which red cells collected from blood lost during surgery are returned to the patient thus minimising the use of donor blood. This is the protocol for a feasibility randomised controlled trial with an embedded qualitative study and feasibility economic evaluation. If feasible, a later definitive trial will test the effectiveness and cost-effectiveness of ICS reinfusion versus donor blood transfusion in ovarian cancer surgery. METHODS AND ANALYSIS: Sixty adult women scheduled for primary or interval ovarian cancer surgery at participating UK National Health Service Trusts will be recruited and individually randomised in a 1:1 ratio to receive ICS reinfusion or donor blood (as required) during surgery. Participants will be followed up by telephone at 30 days postoperatively for adverse events monitoring and by postal questionnaire at 6 weeks and 3 monthly thereafter, to capture quality of life and resource use data. Qualitative interviews will capture participants' and clinicians' experiences of the study. ETHICS AND DISSEMINATION: This study has been granted ethical approval by the South West-Exeter Research Ethics Committee (ref: 16/SW/0256). Results will be disseminated via peer-reviewed publications and will inform the design of a larger trial. TRIAL REGISTRATION NUMBER: ISRCTN19517317.