Effective utilisation of rapid infusion catheters in perioperative care: a narrative review

Abstract

The Rapid Infusion Catheter (RIC) has transformed intravenous (i.v.) access, allowing for rapid fluid delivery peripherally. It may negate the need for a central vein sheath to be placed. This review explores the clinical utility of RICs while addressing technical considerations and potential risks.

The RIC is a large-bore i. v. sheath available in two sizes. Its maximal flow rate is 1200 ml min⁻¹, making it advantageous in significant blood loss scenarios such as trauma and major surgeries. Insertion involves the Seldinger technique.

Monitoring and maintaining the RIC is crucial to detect and address immediate complications such as occlusions, infiltration, phlebitis, and extravasation of infusate. Although the related complications share similarities with those of other peripheral i. v. cannulae, they have a lower risk of occlusion and accidental displacement. Catheter removal should be considered once the patient is stable or alternative access is available to avoid infectious complications. Removal of the RIC needs to be performed by those educated in RIC management.

Maximal flow rate is an essential factor in assessing the performance of i. v. cannulae, and studies have shown that RICs outperform other peripheral and central catheters in this regard.

In conclusion, RIC offers advantages over large-bore central venous access for large-volume rapid infusions, including ease of insertion and reduced severe complications. The RIC demonstrates lower thrombosis rates and a different complication profile than peripherally inserted central catheters.

Understanding the characteristics and applications of RICs can help healthcare professionals make informed decisions about their use in various medical scenarios.