Can local heating reproducibly increase cephalic vein diameters? v1.0
Research type
Research Study
Full title
Local forearm heating prior to venous ultrasound assessment: can this reproducibly increase vein diameters being evaluated for vascular access?
IRAS ID
207270
Contact name
Katy Szczepura
Contact email
Sponsor organisation
University of Salford
Duration of Study in the UK
0 years, 8 months, 4 days
Research summary
End-stage renal disease (ESRD) requiring treatment with renal replacement therapy affects an increasing number of patients every year. Patients requiring dialysis as a consequence of ESRD must have an operation to surgically join an artery to a vein; this create a fistula. Vein diameters are used as preoperative predictors of fistula success and minimum sizes of 2.0 - 2.5mm (measured using ultrasound imaging) are recommended before fistula creation surgery proceeds.
Despite the importance of vein size on the management of ESRD patients, measured diameters can be highly variable due to a large number of factors than can influence the size of blood vessels. Various manoeuvres have been described to dilate veins, optimise diameter measurements and consequently provide greater predictive value of the potential vessel size after distension with arterialised blood flow. Skin temperature can be easily, cheaply and safely manipulated within a clinical environment to increase vein size, yet is not frequently implemented into current practice.
This prospective, feasibility study, which must be completed by May 2017, aims to determine whether local heating of the forearm can improve the reproducibility of cephalic vein diameter measurements made using ultrasound. ESRD patients attending the Vascular Lab as part of their routine care will have cephalic vein diameters measured before and after local heating with an electric heat pad. These patients frequently visit the vascular laboratory on more than one occasion; repeating these measurements on different days enables the effect of heating on daily variability to be evidenced. The magnitude of change in vein sizes in relation to changes in skin temperature will also be assessed. Furthermore inter- and intra-user variability in vein measurements will be assessed to validate the findings of the study.
REC name
South East Scotland REC 01
REC reference
16/SS/0175
Date of REC Opinion
10 Oct 2016
REC opinion
Further Information Favourable Opinion