Passive Leg Raise for Pediatric Peripheral IV Placement

University of Saskatchewan

Status: Completed

Conditions: Children, Only; Anesthesia

Treatments: Procedure: Passive Leg Raise

Study type: Interventional

Funder types: Other

Identifiers

NCT05298137

Bio #3221

Details and patient eligibility

About

The investigators hypothesize peripheral intravenous cannulation (insertion of tube into vein) will be facilitated (decreases the number of attempts) by a passive leg raise (raising the legs at the hip to 45 degree in a child laying on their back) in children.

Full description

Establishing peripheral intravenous (PIV) access in the pediatric population is challenging even in the hands of skilled practitioners.

A passive leg raise (PLR), raising a patient's legs to a 45 degree angle while supine, auto-transfuses the blood volume within the patient's lower extremities into the central venous compartment. Increasing the blood volume in the central venous compartment may also increase the volume and caliber of upper extremity peripheral veins. It remains to be studied whether a PLR increases peripheral vein diameter and if this would facilitate the placement of PIVs in the pediatric population.

Enrollment: 234 patients

Sex: All

Ages: 3 months to 17 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Children ages 3 months to 17 years.
• American Society of Anesthesiology (ASA) physical status 1-3 scheduled for elective surgical procedures under general anesthesia.

Exclusion criteria

• Children undergoing procedures who already have adequate IV access (ie pre-established central or peripheral access).
• Those greater than the age of 17, as this is the age limit for care at the Jim Pattison Children's Hospital.
• Those with any lower limb pathology that limits range of motion.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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234 participants in 2 patient groups

IV Cannulation Without Passive Leg Raise

No Intervention group

Description:

Patients will be randomized to either the passive leg raise (PLR) group or standard care (control group). In both groups baseline measurements of a peripheral vein diameter using ultrasound will be undertaken at the level of the left antecubital fossa with and without a proximally placed venous tourniquet. Those in the control group will then have a peripheral IV (PIV) placed in the ipsilateral arm as the baseline measurements, the number of attempts to successful PIV placement will be recorded. A repeat diameter assessment of the previously assessed vein, number of PIV attempts, and time to successful IV cannulation (measured as the time from skin puncture to successful IV cannulation) will be recorded.

IV Cannulation With Passive Leg Raise

Experimental group

Description:

Patients will be randomized to either the passive leg raise (PLR) group or standard care (control group). In both groups baseline measurements of a peripheral vein diameter using ultrasound will be undertaken at the level of the left antecubital fossa with and without a proximally placed venous tourniquet. Those in the passive leg raise (PLR) group will have their legs elevated to 45 degrees until successful peripheral IV (PIV) placement. A repeat diameter assessment of the previously assessed vein, number of PIV attempts, and time to successful IV cannulation (measured as the time from skin puncture to successful IV cannulation) will be recorded.

Treatment:

Procedure: Passive Leg Raise