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BD Nexiva Diffusics™ Catheter System

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BD Nexiva™ Diffusics™ Closed IV Catheter System

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The BD Nexiva™ Diffusics™ Closed IV Catheter System is built upon the BD Nexiva™ Diffusics™ Closed IV Catheter System with the added benefit of a diffusion catheter tip designed to address common IV challenges in CT, such as sufficient gauge size and catheter stability in the vein, during power injection procedures.

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High flow rates have traditionally required large gauge catheters

Unfortunately, many patients’ vasculature cannot accommodate 18- or even 20-gauge catheters, and using smaller gauge sizes can result in slower flow rates and reduced image quality.

High flow rates may cause catheters to whip around in the vein.

While achieving appropriate flow rates is crucial to image quality, the high flow rates required for power injection during CT may also cause catheters to move or whip around in the vein which may lead to extravasation and could be costly.^1,2

Enable higher flow rates with smaller gauges

The Infusion Therapy Standards of Practice recommend placing the smallest-gauge catheter that will accommodate the prescribed therapy and patient need.³

The diffusion tip on Nexiva Diffusics™ Catheter System enables desired contrast media flow rates to be achieved using a smaller gauge catheter† without compromising image quality. This enables clinicians to perform CT scans that require high flow rates when a patient's vasculature cannot accommodate a large catheter (i.e., 18 or 20 gauge).^‡,4

^†22–24 gauge 
^‡Bench test results may not necessarily be indicative of clinical performance.

Reduce the force of contrast delivery

While flow rates of contrast media are important, the delivery force should also be considered. Nexiva Diffusics™ Catheter System’s diffusion tip reduces the force of contrast delivery by up to 48%,^§ helping decrease the impact of contrast media on the vessel wall.

^§Compared to a non-diffusion-tip catheter. Bench test results may not necessarily be indicative of clinical performance.

Decrease potential catheter motion in vein

High flow rates required for power injection during CT may cause some catheters to move or whip around in the vein. Catheter motion may lead to extravasation, a complication caused by the catheter backing out of the vein.¹

Extravasation may be painful for the patient, potentially resulting in tissue damage.³ The average potential liability for a moderate extravasation is $22k and up to $145k for a severe extravasation.²

Nexiva Diffusics™ Catheter System has been shown to reduce the forces that may cause catheter motion in the vein by up to 67%. This reduction in force stabilizes the catheter in the vein, and prevents the whipping, movement and backing out of the vein that may lead to extravasation.¹

The videos below show catheter motion and extravasation of a non-diffusion tip catheter compared to the stability that Nexiva Diffusics™ Catheter System provides during power injection.

Power injection through a non-fenestrated catheter: Extravasation

Note that, due to the force of the injection, the catheter tip will slowly move, backing out of the vein until the tip escapes the vein completely and contrast media enters the surrounding tissue.

Power injection through a non-fenestrated catheter: Catheter Motion

Note the catheter stays in the vein, but the forces from the power injection create enough turbulence to cause the catheter tip to whip around within the vein. This creates significant motion, potentially irritating or damaging the vessel wall.

Power injection through Nexiva Diffusics™ Catheter System with fenestrated tip: Stability

Note the contrast media flows throughout the vasculature, while the catheter remains still.

^†Videos are from an animal study. Animal study results may not be indicative of clinical performance.

Nexiva Diffusics™ Catheter System Portfolio

Nexiva Diffusics™ Catheter System is offered in two single port configurations: with and without BD MaxZero™ Needle-free Connectors.

Boschi R, Rostagno R. Extravasation of antineoplastic agents: prevention and treatments. Pediatric Reports. 2021;4(e28);98-100.
Paice T. Economic impact of an extravasation. an analysis. Imaging Economics. 2007;20(3):14.
Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2024.
Johnson PT, Christensen GM, Fishman EK. IV contrast administration with dual source 128-MDCT: a randomized controlled study comparing 18-gauge nonfenestrated and 20-gauge fenestrated catheters for catheter placement success, infusion rate, image quality and complications. Am J Roentgenol. 2014;202(6):1166-70.

BD-22672 (05/24)

Nexiva Diffusics™ Catheter System for cardiac CTs

The all-in-one closed IV catheter system leverages a fenestrated tip to accommodate power injection at high flow rates (e.g., 6.5 mL/sec for 22 G) and provides higher vascular attenuation for coronary CTA (CCTA) when compared with non-fenestrated catheters at the same flow rates.  

Practice guidelines include using a fenestrated peripheral IV catheter (PIVC), ensuring the IV used is rated to administer flow rates required for coronary CTA (e.g., 5–7 mL/s).¹

ensures high risk patients are appropriately triaged to cardiac catheterization¹
offers rapid evaluation of the degree of coronary stenosis and atherosclerosis¹
allows significant reduction in time-to-discharge¹

Appropriate utilization and patient selection¹
Requires high contrast media injection flow rates²

Extracting potential clinical and economic value for CCTA includes improving patient outcomes, lowering healthcare costs and preventing unnecessary diagnostic procedures.¹

Watch a free webinar featuring Dr. Wesley T. O’Neal, MD, FACC, Medical Director, Cardiovascular CT Cone Health Heart & Vascular Center of Greensboro NC

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Elevate infusion experiences for your patients

Fenestrated catheter in CCTA^1,2

Diagnostic, high-quality images

Expedite triage

Reduce risk of complications<sup>3</sup>

Reduce risk of complications³

Achieving high diagnostic accuracy with the lowest possible radiation dose requires careful preparation of CTA patients.¹ Adequate peripheral IV access is necessary to ensure diagnostic, high-quality images.²

Image quality is affected by the attenuation achieved in MDCT coronary angiography, particularly in the small coronary arteries. Overall diagnostic accuracy improves significantly when higher intracoronary attenuation is achieved.⁴ Nexiva Diffusics™ Catheter System has been shown to provide higher vascular attenuation for CCTA when compared with non-fenestrated catheters at the same flow rates.*^,5,6

Morbid obesity in CCTA
Morbid obesity is a scenario where CCTA may be difficult or non-diagnostic. Strategies to improve image quality include ensuring high-flow IV contrast injections of 6–7 mL/sec.¹ Nexiva Diffusics™ Catheter System can accommodate power injection at 6.5 mL/sec for 22 G and up to 15 mL/sec for 18 G.

_{*The catheter system has been tested at the flow rates noted for contrast media viscosity 27.5 cP(mPa-s). However, due to variations in add-on devices, tubing, contrast media temperature and pressure limit settings, these flow rates may not be achievable.}

Acute chest pain in CCTA
CCTA is a proven strategy to safely expedite diagnosis and limit resource utilization for patients presenting with acute chest pain (ACP) in the ED with no known prior coronary artery disease.¹ 

CCTA has established itself as the preferred first-line test for ACP triage in select patients, and is also now recognized as a Class I indication by multiple international professional societies, including the American College of Cardiology, the American College of Radiology, and the European Society of Cardiology.¹

Infusion Therapy Standards of Practice state to consider a fenestrated catheter for a contrast-based radiographic study.⁸ Nexiva Diffusics™ Catheter System is the only peripheral IV catheter with a fenestrated catheter tip specifically designed for power injection.

Nexiva Diffusics™ Catheter System is designed to enable contrast delivery during CT with smaller IV catheters without increasing the risk of complications.

The stabilizing catheter system reduces: 

Force of contrast delivery by up to 48%*
Destabilizing effects that may lead to extravasation³
Potential for the catheter to move or whip around in the vein
Chance of phlebitis by up to 29%^†,7

These factors enable power injection with smaller IV catheters without an increased risk of complications. Nexiva™ Catheter System has also been associated with lower complications in a number of studies.

Clinical evidence

*Compared to a non-diffusion tip catheter. Bench test results may not necessarily be indicative of clinical performance.
^†BD Nexiva™ Catheter System with a PTFE catheter demonstrated a 29% reduction in phlebitis rates when compared to an open system.

Nexiva Diffusics™ Catheter System Portfolio

Nexiva Diffusics™ Catheter System is offered in two single port configurations: with and without BD MaxZero™ Needle-free Connectors.

Maroules C, Rybicki F, Ghoshhajra B, et al. 2022 use of coronary computed tomographic angiography for patients presenting with acute chest pain to the emergency department. Journal of Cardiovascular Computed Tomography. 2023;17:146-163. https://doi.org/10.1016/j.jcct.2022.09.003.
Fischer AM, Riffel P, Henzier T, et al. More holes, more contrast? Comparing an 18-gauge non-fenestrated catheter with a 22-gauge fenestrated catheter for cardiac CT. PLoS ONE 15(6):e0234311. https://doi.org/10.1371/journal.pone.0234311
Boschi R, Rostagno R. Extravasation of antineoplastic agents: prevention and treatments. Pediatric Reports. 2021;4(e28);98-100.
Cademartiri F, Mollet N, Lemos P, et al. Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography. AJR. 2006;187:W430-W433. doi:10.2214/AJR.05.1406
Harraz M, Abouissa A, Kamr W. Closed versus conventional IV catheter in performing coronary CT Angiography. Egyptian Journal of Radiology and Nuclear Medicine. (2020) 51:89. https://doi.org/10.118/s43055-020-00211-4.
Kim JeongJae, Kim Eun Jeong, Hur Jee Hye, et al. The Usefulness of Fenestrated Intravenous Catheters Compared with Nonfenestrated Catheter for Cardiac Multidetector Computed Tomography. J Comput Assist Tomogr. Volume 43, Number 3, May/June 2019.
González López J, Arribi Vilela A, Fernández Del Palacio E, et al. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect. 2014;86(2):117-126.
Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2024.

Clinical evidence

Nexiva Diffusics™ Catheter System is built on the Nexiva™ platform. Nexiva™ has been shown to deliver higher clinician satisfaction, improved clinician safety and a reduction in overall complication rates versus non-integrated, open systems.^1–3

The platform is backed by evidence in peer-reviewed journals from as early as 2009⁴ to as recently as 2024.⁵

Nexiva™ Diffusics Closed IV Catheter System is also backed by peer-reviewed journals and infusion guidelines. Infusion Therapy Standards of Practice state to consider a fenestrated catheter for a contrast-based radiographic study and in coronary CTA.⁶ Nexiva Diffusics™ Catheter System is the only peripheral IV catheter with a diffusion catheter tip specifically designed for power injection.

Closed IV Catheter System	Comparative  catheter	Data gathered	Year published	Study type	Journal	Authors
Nexiva Diffusics™	Smiths Jelco ProtectIV^® Plus	Aortic enhancement levels, catheter placement success, complications, contrast volume, extravasation, image quality, infusion rate, maximum pressure	2014	RCT⁷	American Journal of Roentgenology	Johnson PT, Christensen GM, Fishman EK.
Nexiva™	Various	Catheter failure, dislodgement, occlusion, phlebitis	2024	Systematic review/ meta analysis⁵	Journal of Vascular Access	Gidaro A, Quici M, Giustivi D, et al.
Nexiva™	BD Insyte Autoguard™	Dwell time, complications, dislodgement, occlusion, infiltration, phlebitis	2023	RCT⁸	European Journal of Oncology Nursing	Gerceker GO,   Yildirim BG,   Onal A, et al.
Nexiva™	B. Braun  Introcan  Safety^® BD Insyte   Autoguard™	Catheter-associated bloodstream infection, clinician satisfaction, cost savings/utilization reduction, dwell time, dislodgement/leaking, infiltration/extravasation, local infection, insertion success, occlusion, phlebitis	2022	RCT¹	Journal of Hospital Medicine	Rickard CM,   Larsen E,   Walker RM, et al.
Nexiva™	Smiths Jelco ProtectIV^®Plus	Clinician satisfaction, dwell time, infection, infiltration, pain, phlebitis	2019	Prospective, quasi-experimental⁹	Journal of Infusion Nursing	Penoyer D, Fowler S, Bennett M
Nexiva™	None	Blood exposure, dislodgement, kinking, leaking, phlebitis, restarts	2017	Observational¹⁰	Journal of Vascular Access	deRosenroll A
Nexiva™	Medikit	Bending and kinking, blood exposure, cost savings/utilization reduction, dislodgement, dwell time, extravasation, insertion success, obstruction, phlebitis	2014	Quasi-randomized study¹¹	Journal of Vascular Access	Tamura N, Abe S, Hagimoto K, et al.
Nexiva™	B. Braun Vasocan^® Safety	Catheter-related infection, cost savings/utilization reduction, dwell time, infiltration/extravasation, insertion success, occlusion, pain, painful hematoma, phlebitis	2014	RCT²	Journal of Hospital Infection	González López J, Arribi Vilela A, Fernández Del, Palacio E, et al.
Nexiva™	B. Braun Introcan Safety^® (non-winged) with StatLock	Clinician satisfaction, cost savings/utilization reduction, dislodgement, dwell time, infiltration, insertion success, leaking, phlebitis	2010	RCT³	Journal of Infusion Nursing	Bausone-Gazda D, Lefaiver CA, Walters SA, et al.
Nexiva™	None	Clinician satisfaction, clotting, dislodgement, infiltration, leaking, restarts, securement	2009	Pre-and post-use survey⁴	Journal of the Association of Vascular Access	McNeil E, Hines N, Phariss R

Rickard CM, Larsen E, Walker Rachel M, et al. Integrated versus nonintegrated peripheral intravenous catheter in hospitalized adults (OPTIMUM): A randomized controlled trial. J Hosp Med. 2022;1-12.
González López J, Arribi Vilela A, Fernández Del Palacio E, et al. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect. 2014;86(2):117-126.
Bausone-Gazda D, Lefaiver CA, Walters SA. A randomized controlled trial to compare the complications of 2 peripheral intravenous catheter-stabilization systems. J Infus Nurs. 2010;33(6):371-384.
McNeil E, Hines N, Phariss R. A clinical trial of a new all-in-one peripheral-short catheter. JAVA. 2009;14(1):46-51.
Gidaro A, Quici M, Giustivi D, et al. Integrated short peripheral intravenous cannulas and risk of catheter failure: a systematic meta-analysis. J Vasc Access. 2024.
Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2024.
Johnson PT, Christensen GM, Fishman EK. IV contrast administration with dual source 128-MDCT: a randomized controlled study comparing 18-gauge nonfenestrated and 20-gauge fenestrated catheters for catheter placement success, infusion rate, image quality and complications. Am J Roentgenol. 2014;202(6):1166-70.
Gerceker GO, Yildirim BG, Onal A, et al. The effect of the closed intravenous catheter system on first insertion success, indwelling time, and complications in pediatric hematology and oncology patients: a randomized controlled study. Eur J Oncol Nurs. 2023 Dec:67:102430. doi: 10.1016/j.ejon.2023.102430. Epub 2023 Oct 7.
Penoyer D, Fowler S, Bennett M. Evaluation of the Use of Open Versus Closed Short Peripheral Catheters on Catheter Dwell Time. J Infus Nurs. 2019;42(6):276-282.
deRosenroll A. Peripheral intravenous catheters: Improving outcomes through change in products, clinical practice and education. Vasc Access. 2017;11(1):7-12.
Tamura N, Abe S, Hagimoto K, et al. Unfavorable peripheral intravenous catheter replacements can be reduced using an integrated closed intravenous catheter system. J Vasc Access. 2014;15(4):257-263.