The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study

Abstract Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device, yet up to 50% fail. Many pathways to failure are mechanistic and related to fluid mechanics, thus can be investigated using computational fluid dynamics (CFD). Here we used CFD to investigate typica...

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Autores principales:	Russell Piper, Peter J. Carr, Lachlan J. Kelsey, Andrew C. Bulmer, Samantha Keogh, Barry J. Doyle
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/495905aebc914328b0be0803a65b589e
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spelling	oai:doaj.org-article:495905aebc914328b0be0803a65b589e2021-12-02T15:08:01ZThe mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study10.1038/s41598-018-21617-12045-2322https://doaj.org/article/495905aebc914328b0be0803a65b589e2018-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-21617-1https://doaj.org/toc/2045-2322Abstract Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device, yet up to 50% fail. Many pathways to failure are mechanistic and related to fluid mechanics, thus can be investigated using computational fluid dynamics (CFD). Here we used CFD to investigate typical PIVC parameters (infusion rate, catheter size, insertion angle and tip position) and report the hemodynamic environment (wall shear stress (WSS), blood damage, particle residence time and venous stasis volumes) within the vein and catheter, and show the effect of each PIVC parameter on each hemodynamic measure. Catheter infusion rate has the greatest impact on our measures, with catheter orientation also playing a significant role. In some PIVC configurations WSS was 3254 times higher than the patent vein, and blood damage was 512 times greater, when compared to control conditions. Residence time is geometry-dependent and decreases exponentially with increasing insertion angle. Stasis volume decreased with increasing infusion rate and, to a lesser degree, insertion angle. Even without infusion, the presence of the catheter changes the flow field, causing low velocity recirculation at the catheter tip. This research demonstrates how several controllable factors impact important mechanisms of PIVC failure. These data, the first of their kind, suggest limiting excessive infusion rates in PIVC.Russell PiperPeter J. CarrLachlan J. KelseyAndrew C. BulmerSamantha KeoghBarry J. DoyleNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-12 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Russell Piper Peter J. Carr Lachlan J. Kelsey Andrew C. Bulmer Samantha Keogh Barry J. Doyle The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
description	Abstract Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device, yet up to 50% fail. Many pathways to failure are mechanistic and related to fluid mechanics, thus can be investigated using computational fluid dynamics (CFD). Here we used CFD to investigate typical PIVC parameters (infusion rate, catheter size, insertion angle and tip position) and report the hemodynamic environment (wall shear stress (WSS), blood damage, particle residence time and venous stasis volumes) within the vein and catheter, and show the effect of each PIVC parameter on each hemodynamic measure. Catheter infusion rate has the greatest impact on our measures, with catheter orientation also playing a significant role. In some PIVC configurations WSS was 3254 times higher than the patent vein, and blood damage was 512 times greater, when compared to control conditions. Residence time is geometry-dependent and decreases exponentially with increasing insertion angle. Stasis volume decreased with increasing infusion rate and, to a lesser degree, insertion angle. Even without infusion, the presence of the catheter changes the flow field, causing low velocity recirculation at the catheter tip. This research demonstrates how several controllable factors impact important mechanisms of PIVC failure. These data, the first of their kind, suggest limiting excessive infusion rates in PIVC.
format	article
author	Russell Piper Peter J. Carr Lachlan J. Kelsey Andrew C. Bulmer Samantha Keogh Barry J. Doyle
author_facet	Russell Piper Peter J. Carr Lachlan J. Kelsey Andrew C. Bulmer Samantha Keogh Barry J. Doyle
author_sort	Russell Piper
title	The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
title_short	The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
title_full	The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
title_fullStr	The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
title_full_unstemmed	The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
title_sort	mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/495905aebc914328b0be0803a65b589e
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The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study

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