Open catheterization of the peripheral vein. Relevance and benefits

Abstract

BACKGROUND: There are situations where the walls of peripheral veins collapse due to hypovolemia and hypotension, and central venous catheterization or intraosseous access is undesirable due to significant hypocoagulation and high risk of iatrogenic complications. In such cases, venesection on the upper or lower limb can be the preferred procedure for ensuring venous access. AIM: The aim of this study is to compare the possibilities of peripheral vascular access through venesection with open catheterization using modern catheters in an experiment on laboratory animals. MATERIALS AND METHODS: Under combined anesthesia, venesection of the superficial jugular vein was performed on 6 rabbits. During the surgery and in the early postoperative period, intravenous infusions were administered through a catheter. The catheter was removed 1 day after the surgery. In the postoperative period, the rabbits received physiological nutrition, care, and dressings until the sutures were removed. On the 7th day after the surgery, an ultrasound examination of the surgical area was conducted to assess the patency of the vein. The rabbits were euthanized on the 14th, 28th, and 37th day after the surgery for subsequent pathological and anatomical examination. RESULTS: All the installed catheters for intravenous infusions functioned until removal at 1 day post-intervention. Postoperative wounds healed by primary intention, and sutures were removed on the 7th day after surgery. According to the results of ultrasonographic examination and data from pathological-anatomical investigation, no complications were detected in the venesection area in all cases, and macroscopically, the jugular veins of all operated rabbits were patent. CONCLUSIONS: Open catheterization of the peripheral vein allows access for infusions and preserves the vessel for further use. For a correct understanding of the vascular access method with vein crossing and ligation, it is advisable to avoid terminological distortion of meaning and use the term “catheterization by venesection”. Open catheterization is an alternative to traditional venesection catheterization and may be recommended if percutaneous venous catheterization and intraosseous access are not possible.