Efficacy of AirGLovE in Difficult Venous Access

Study Overview
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Brief Summary
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To determine whether Airglove™ warming device dilates upper limb veins to the same degree as the warm water immersion (WWI) method.

Detailed Description
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Failure to cannulate to gain intra-venous access is a common occurrence in patients undergoing chemotherapy, obese patients, intravenous drug users and those with chronic medical problems leading to peripheral venous collapse. Difficulty in gaining IV-access is a serious medical consequence since important life-saving drugs, fluids, blood transfusions, and other medication are usually given via the intravenous route. Most chemotherapy units in the UK rely on venous dilation by immersing the forearm of patients with difficult to cannulate veins (DTCV) into a bucket of warm water. There are however, limitations in this method such as controlling water temperature and ensuring proper sterility. A new device Airglove™ has been developed which directs warm air over the forearm in a polythene sleeve causing venodilation. Preliminary studies in chemotherapy patients suggest that the Airglove™ causes venodilation to the extent of the warm water immersion technique, however further evidence is required with testing on normal healthy volunteers. Aims and Objectives: To determine whether Airglove™ warming device dilates upper limb veins to the same degree as the warm water immersion (WWI) method.

Official Title
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Assessment by Ultrasound of the Degree of Venous Dilation, Comparison Between Venodilation by Airglove (TM) Versus Warm-water Immersion (WWI)

Conditions
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Cancer

Intervention / Treatment
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* Device: Airglove (TM)
* Device: Warm-water Immersion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants > 18 years old Able to give written informed consent Able to understand and complete questionnaire forms independently Exclusion Criteria: Participants < 18 years old Participants with cancer and/or undergoing chemotherapy Participants with difficult to cannulate veins (DTCV) Participants with lymphoedema in either hand Participants with pre-existing Raynaud's disease Participants with Diabetes (Type 1 & 2) Participants with generalised anxiety disorder Participants with diagnosis of hypertension Participants with any cardiovascular disease, previous stroke, episodes of DVT, recent treatment for venous thromboembolism (VTE), recently administered heparin, participants on warfarin or any anticoagulant treatment (including NOACs). Participants not able to give written informed consent Participants not able to comprehend or complete questionnaire forms independently

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Prospective cross-sectional comparative study
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Airglove arm<br>Participants on the airglove arm were subjected to warming of their forearms using the Airglove device at 38.5oC. | Device: Airglove (TM)<br>* A sterile polythene-balloon was inflated around the forearm using the AirGloveTM to 38.5oC at setting number-3 for 3 minutes, then removed and the degree of venodilation assessed by ultrasound.<br>|
| Experimental: Warm-water Immersion arm<br>Participants on the WWI arm were subjected to warming by immersing their forearms into a bucket of warm water at 38.5oC. | Device: Warm-water Immersion<br>* The upper limbs (to the level of mid-humerus) of participants were immersed in a container filled with a mix of cold-and warm tap-water to 38.5oC for 3 minutes in the WWI method. Arms were towel-dried, and the degree of venodilation was assessed by ultrasound<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Name of Measurement: Change in measurement of vein diameter by ultrasound | MEASUREMENT TOOL: GE Logic S8 multi-frequency linear-array transducer (L6-15MHz), two-dimension B-mode ultrasound | Change from baseline measurements taken within 2 minutes of the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cannulation,, Chemotherapy, Difficult venous access, Difficult venepuncture, Cancer