出版社：Japan Society of Circulation Control in Medicine
摘要：Purpose: We compared the penetration force of eight brands of 18-gauge intravenous catheters using an original experimental device. Differences in penetration force were examined for 20 catheters for each brand. Method: The inner needles of the intravenous catheters were inserted into a 0.08-mm polyethylene film at a 30- or 45-degree penetration angle by a push-pull gauge moved by a motor at 4.5 mm/sec. until the outer catheter penetrated the film. Each intravenous catheter consisted of an inner needle and an outer catheter. Inner needles were divided into two groups according to tip grinding method: Lancet or Backcut. Catheter tips were classified in two designs: acute- and obtuse-tapering. We studied the impact of these inner needle grinding methods and catheter tip designs on penetration forces, and catheter damage was observed under an electron microscope. Result: At a 45-degree penetration angle, the penetration force of inner needles ranged from 25 to 45 grams, while the penetration force of catheters ranged from 35 to 58 grams, with no obvious influence of inner needle tip grinding method or catheter tip design on penetration force. At a 30-degree penetration angle, penetration force was lower in catheters with an obtuse-tapering design; the penetration force was significantly higher (120 g) in Surflo® catheters with acute-tapering design. All six Surflo® catheters had visible tip damage under the electron microscope. The seven other brands of catheters showed no tip damage regardless of inner needle grinding method. Conclusion: In clinical practice, the insertion angle for peripheral venipuncture is 30 degrees or less. Our results show that catheters with an obtuse-tapering tip design were better than those with an acute-tapering tip design. If an intravenous catheter with an acute-tapering tip is inserted into a vein at an obtuse angle, the catheter tip will be damaged, resulting in insertion failures.
