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Investigating the effect of local warming on vein diameter in the antecubital area in adults aged 20-40 years

25 April 2019
Cannulation
02 April 2019
Volume 28 · Issue 8

Abstract

Background:

peripheral intravenous cannulation is the most prevalent invasive procedure performed on patients admitted to hospital. The procedure is not always easy to undertake and can lead to problems for the patient and nurse. Alongside various procedures, local warming is one technique that could be used to increase the diameter of superficial veins. This prospective non-randomised trial aimed to determine the effect of local warming on vein diameter in the antecubital area in adults aged 20–40 years.

Method:

the subjects included 55 volunteers who were in good health. The cephalic vein diameter of the right arm cubital area was measured for each participant using ultrasound guidance. The arm was warmed for 10 minutes using a heating device maintained at 42ºC. A second ultrasound scan was then undertaken immediately afterwards and cephalic vein diameter measured.

Results:

local warming increased the cephalic vein diameter in the cubital area by 0.43±0.4 mm. There was no significant relationship between change in cephalic vein diameter and participants' gender, age or body mass index.

Conclusion:

the results indicate that the application of heat is an effective technique for venodilation and could be considered in emergencies or in cases when other veins are difficult to access.

Peripheral intravenous cannulation is the most common minimally invasive procedure performed on hospitalised patients (Keleekai et al, 2016; Cooke et al, 2018), of whom up to 70% are estimated to require the procedure (Rickard et al, 2012). In many situations, such as an emergency, the insertion of a peripheral cannula will save a patient's life (Carr et al, 2016). More generally, peripheral cannulas are used for procedures ranging from the administration of injections and the delivery of nutrients and substances, such as blood and its products, to haemodialysis—they are familiar to health professionals in their daily practice (Farrelly and Stitelman, 2016; Smith and Schoch, 2016; Tokizawa et al, 2017). In the UK alone, one in three hospitalised patients have peripheral cannulas in situ (Boyd et al, 2011), costing about £29 million of the £4.5 billion that the NHS spends annually on clinical products in acute care (Guerrero, 2019).

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Peripheral intravenous cannulation
Local warming
Antecubital cephalic vein
Heating device
Topical heat