Peripheral Intravenous Catheter Complications Research Articles

Smaller-gauge catheters and greater body weights are associated with increased risk of peripheral intravenous catheter complications in cats hospitalized in the critical care unit.

To identify risk factors associated with peripheral intravenous catheter (PIVC) complications in cats hospitalized in the critical care unit (CCU). 120 cats admitted to the CCU between October 2022 and September 2023. This prospective, observational study was performed at a single veterinary teaching hospital. Cats hospitalized in the CCU for ≥ 24 hours were evaluated for enrollment. Peripheral intravenous catheters were placed by trained personnel following a standardized protocol and monitored for complications. PIVC complications were classified as extravasation, phlebitis, dislodgement, occlusion, line breakage, or patient removal. Median PIVC dwell time was 42.25 hours (range, 24.25 to 164.25 hours). Overall PIVC complication rate was 18.3% (22/120), with extravasation (7/120 [5.8%]) and dislodgement (7/120 [5.8%]) being the most frequently recorded complications. Multivariable analysis identified that for each kilogram increase in body weight there is a higher likelihood of a PIVC complication (OR, 1.46; 95% CI, 1.03 to 2.05; P = .03). Additionally, use of a larger-gauge (20-gauge vs 22-gauge) PIVC is associated with a significantly lower likelihood of a PIVC complication (OR, 0.13; 95% CI, 0.03 to 0.56; P = .006). These results suggest that smaller-gauge (22-gauge) PIVCs and greater body weights are associated with an increased risk of complications in cats hospitalized in the CCU. When possible, a larger-gauge (20-gauge) PIVC should be placed in cats admitted to the CCU.

The Prevalence and Associated Factors of Peripheral Intravenous Complications in a Thai Hospital.

Complications of peripheral intravenous catheters (PIVCs) remain a major contributor to health care costs and are a patient safety problem. The objective of this cross-sectional descriptive study was to examine the prevalence of complications and factors associated with complications from peripheral intravenous fluid administration. The study was conducted at a tertiary care hospital in Thailand. The instruments were developed from the literature review. Data were analyzed using SPSS statistics, version 22. The study examined 441 patients with a total of 497 PIVC sites. Phlebitis (level 1 and 2 only) occurred at 2.41% of all sites; infiltration (level 1 and 2 only) occurred at 1.01% of all sites, and extravasation (mild and moderate only) occurred at 0.60% of all sites. Factors associated with the occurrence of infiltration complications included receiving intravenous (IV) crystalloids (P = .03) and receiving IV analgesic drugs (P = .001). Age was statistically significantly related to extravasation complications (P = .001). Nurses should be aware of possible complications from peripheral intravenous fluid administration, especially in older patients and those receiving IV crystalloids or analgesic drugs.

Increased risk of complications in lower versus upper limb peripheral intravenous cannulation in children with severe neurological impairment.

Obtaining peripheral intravenous catheter (PIVC) access in children with severe neurological impairment (SNI) is often challenging and commonly associated with complications, including dislodgement, phlebitis and extravasation. In severe cases, extravasation injury may lead to tissue necrosis, ulceration and long-term morbidity. The aim of this study was to determine the relative incidence of PIVC complications secondary to lower limb cannulation, compared to upper limb, in children with SNI. A single centre, retrospective, observational review was conducted. Patients with SNI, admitted at a tertiary paediatric centre over 6months between July and December 2022, were included. One-hundred fifty-five PIVC procedures were conducted in 110 children over the study period. Complications were more common in lower limb PIVCs (12/16, 75%) compared to upper limb (58/139, 42%), p = 0.01. Upper limb cannulation is preferred in children with SNI.

Nomogram for Predicting the Risk of Complications in Hospitalized Children With Peripheral Intravenous Catheters.

The aim of the study is to identify the hospitalized children at risk of peripheral intravenous catheter (PIVC) complications by severity prediction. The study included the data of 301 hospitalized children with PIVC complications in 2 tertiary teaching hospitals. A researcher-designed tool was used to collect risk factors associated with PIVC complications. Predictors of PIVC complications at univariate analysis and multivariable logistic regression analysis by backward stepwise. A nomogram was constructed based on the results of the final multivariable model, making it possible to estimate the probability of developing complications. A total of 182 participants (60.5%) had a moderate injury from PIVC complications. Multivariable logistic regression analysis indicated that the vascular condition, limb immobilization, needle adjustment in venipuncture, infusion length, infusion speed, and insertion site were independent predictors. The nomogram for assessing the severity of PIVC complications indicated good predictive accuracy (area under the curve = 0.79) and good discrimination (concordance index = 0.779). Decision curve analysis demonstrated that the nomogram was a good clinical value with a wide range of threshold probabilities (4%-100%). The risk prediction model has good predictive performance, and the nomogram provides an easy-to-use visualization to identify the severity of PIVC complications and guide timely nursing care management.

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

PurposeThe primary purpose of this research is to evaluate the effect of two different catheter systems (closed IV catheter system: BD Nexiva™, peripheral open IV catheter: BD Insyte™ Autoguard™) on first insertion success, catheter indwelling time, and the catheter complications. MethodThis randomized controlled study used a single-blind and parallel trial design guided by the CONSORT checklist. The “Peripheral Intravenous Catheter (PIVC) Bundle” was applied to all patients. A total of 214 catheters of 38 patients were included in the intervention (BD Nexiva™) (n = 107 catheter) and control (open IV catheter) groups (n = 107 catheter) of the study. The indwelling time and PIVC complications were followed. ResultsThe mean age of the patients in the study group was 5.9 ± 2.2, and the mean age of the patients in the control group was 5.7 ± 1.9. The PIVC was successfully placed in 68.2% of the patients in the study group and in 65.4% of the patients in the control group at the first attempt. It was determined that the indwelling time was 4.9 ± 3.9 (max. 20.25 days) in the study group and 2.9 ± 2.8 (max. 11.25 days) days in the control group. The complication rates were found to be 86.8 for the study group and 166.9 for the control group in 1000 catheter days. In this study, no difference was found in terms of complication. ConclusionsThe PIVC indwelling time is longer in patients with the closed IV catheter system. These new technology PIVCs can be used for this special patient population. Clinicaltrials.gov identifierNCT05769452.

Factors affecting the patency and complications of peripheral intravenous catheters in newborns.

Peripheral intravenous catheters (PICs) are necessary for medication, nutrient, and fluid administration in pediatric patients. However, PICs are uneasy to access and maintain in young infants. This study identified risk factors affecting the complications and patency of PICs. This retrospective cohort study included neonates and infants aged <4 months. All PICs inserted in the neonatal intensive care unit and intermediate care nursery were analyzed more than 5 months. The variables included gestational age, age and body weight at PIC insertion, insertion site, methods to maintain PIC patency (continuous intravenous drip [CIVD] versus intermittent flushing), fluid infusion rate and osmolarity, and ampicillin and cefotaxime concentrations. The effects of these variables on PIC complications and lifespan were assessed using binary logistic regression analysis and a general linear model, respectively. In total, 315 PICs were analyzed. The mean indwelling time was 33.8±21.5h and complication rate was 82.2%. The most frequent complications were infiltration (55.9%) and leakage (22.2%). The infusion rate and method to maintain PICs significantly impacted PIC patency. A negative correlation was noted between the infusion rate and PIC patency, with the patency decreasing by 0.9h (p=0.047) on increasing the infusion rate by 1mL/h. Notably, compared with intermittent flushing, CIVD using a hypertonic solution significantly decreased PIC patency by 14h (p=0.006). As the patients' age increased by a month, the complication risk decreased by 35% (p=0.027). However, as the infusion rate increased by 1mL/h, the complication risk increased by 17% (p=0.018). Intermittent flushing may be preferred over CIVD to preserve PIC patency. An increased infusion rate is correlated with decreased PIC patency and increased complications. For the peripheral administration of ampicillin, we recommended preparing final concentrations below 50mg/dL to prevent PIC complications.

Cost effectiveness of ultrasound-guided long peripheral catheters in difficult vascular access patients.

Peripheral intravenous catheter (PIVC) placement is a routinely performed invasive procedure in hospital settings with an unacceptably high failure rate that can result in significant costs. This investigation aimed to determine the cost-effectiveness of using long peripheral catheters (LPC) versus standard short peripheral catheters (SPC) in the difficult vascular access (DVA) population. A secondary analysis was performed of a randomized control trial that compared a 20-gauge 4.78 cm SPC to a 20-gauge 6.35 cm SPC for the endpoint of survival. This study assessed cost-effectiveness of the comparative interventions. Costs associated with increased hospitalization length of stay due to PIVC failure, including labor, materials, equipment, and treatment delays were estimated by utilizing healthcare resource utilization data. Cost-effectiveness of the LPC was analyzed through the incremental cost-effectiveness ratio, the cost-effectiveness acceptability curve, and the incremental net benefit. A sensitivity analysis was conducted to evaluate the robustness of the results during the time interval of PIVC insertion. Among the 257 patients, the average total cost for therapy was lower in the LPC group compared to the SPC group ($400 vs $521; mean difference -$121, 95% bootstrapped CI -$461 to $225). A marginally significant absolute difference of complication averted was found for LPC versus SPC (10.8%, p = 0.07). The estimated incremental cost-effectiveness ratio (ICER) for LPC as compared with SPC was -$1123 (95% bootstrapped CI -$8652 to $5964) per complication averted. In a willingness to pay (WTP) analysis, as WTP = $0, the incremental net benefit (INB) $121 was positive, indicating LPC was less costly. Analysis of PIVCs that survived ⩽48 h (n = 134) demonstrated a lower average total cost for therapy among the LPC group ($418 vs $531; mean difference -$113, 95% bootstrapped CI -$507 to $282). Forty-seven of 66 (71.2%) LPCs did not experience a complication, compared with 37 of 68 (54.4%) SPCs, resulting in a significant absolute difference of complication adverted of 16.8% (p = 0.04). In addition, with a positive slope, the INB $113 was positive as WTP = $0, indicating LPC was estimated to be cost-effective. When using ultrasound guidance for vascular access, LPCs are potentially a cost-effective strategy for reducing PIVC complications in DVA patients compared to SPCs. Given this finding, ultrasound-guided LPCs should be routinely considered as first-line among the DVA population in order to improve their overall care and wellbeing.

Fewer peripheral intravenous catheter complications in hospitalized dogs when force-activated separation devices are used versus not used in a randomized controlled clinical trial.

To determine whether the use of a force-activated separation device (FASD) lowers the incidence risk of peripheral intravenous catheter (PIVC) complications in hospitalized dogs. 367 dogs that were hospitalized and received IV fluids between January 11 and March 25, 2021. A prospective, randomized controlled clinical trial was performed. Dogs hospitalized and receiving IV fluids for at least 24 hours were randomized to the FASD group or control group. PIVCs were placed following a standardized protocol. Dogs in the FASD group had the FASD device attached to their PIVC according to manufacturer instructions. For both groups, all PIVC complications were documented, and each complication was classified as extravasation, phlebitis, dislodgement, occlusion, or line breakage. Results from 367 dogs (FASD group = 180, control group = 187) underwent analysis. The proportion of PIVC complications was significantly (P = .004) lower for the FASD group (8.9% [16/180]) versus the control group (24.6% [46/187]). Following adjustment for differences in hospitalization time, the odds of a dog in the FASD group having a PIVC complication was approximately one-third the odds of those in the control group (OR, 0.33; 95% CI, 0.17 to 0.63; P = .001). Results indicated that the use of a FASD in hospitalized dogs receiving IV fluids is warranted to lower the incidence of PIVC complications and may also limit patient discomfort, owner expense, and staff time devoted to managing PIVC complications. Further research investigating its use in cats and other species should be considered.

Complications of peripheral intravenous catheters and risk factors for infiltration and phlebitis in children

ABSTRACT Aim: This study aimed to identify the types of complications of peripheral intravenous catheters (PIVCs) in hospitalised children and possible risk factors for the development of extravasation, infiltration and phlebitis. Method: The study was conducted in the largest children’s hospital in a region of Turkey, with a bed capacity of 354 and 1400 employees, which provides care only to paediatric patients aged from newborn to 18 years old. In this 5-month prospective study, the complications of PIVCs in hospitalised children and risk factors leading to the development of extravasation, infiltration and phlebitis were recorded. During morning and afternoon daily visits, the researcher examined catheter sites for complications and indications for removal. Results: The study covered 244 patients aged from 1 month to 17 years, 575 PIVCs and 1600 catheter days. The rates of infiltration and phlebitis observed in children with PIVCs were 8.7 % and 15.8% respectively. Logistic regression revealed that using 22- and 24-gauge catheters, hospitalisation in the surgery ward and continuous infusion were significant independent risk factors for the development of infiltration (P&amp;lt;0.001). Direct logistic regression revealed that age in months, hospitalisation in a surgery ward and placement of the catheter in the veins of the antecubital fossa were significant independent risk factors for the development of phlebitis (P&amp;lt;0.001). Conclusion: Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.

Complications of peripheral intravenous catheters and risk factors for infiltration and phlebitis in children.

This study aimed to identify the types of complications of peripheral intravenous catheters (PIVCs) in hospitalised children and possible risk factors for the development of extravasation, infiltration and phlebitis. The study was conducted in the largest children's hospital in a region of Turkey, with a bed capacity of 354 and 1400 employees, which provides care only to paediatric patients aged from newborn to 18 years old. In this 5-month prospective study, the complications of PIVCs in hospitalised children and risk factors leading to the development of extravasation, infiltration and phlebitis were recorded. During morning and afternoon daily visits, the researcher examined catheter sites for complications and indications for removal. The study covered 244 patients aged from 1 month to 17 years, 575 PIVCs and 1600 catheter days. The rates of infiltration and phlebitis observed in children with PIVCs were 8.7 % and 15.8% respectively. Logistic regression revealed that using 22- and 24-gauge catheters, hospitalisation in the surgery ward and continuous infusion were significant independent risk factors for the development of infiltration (P<0.001). Direct logistic regression revealed that age in months, hospitalisation in a surgery ward and placement of the catheter in the veins of the antecubital fossa were significant independent risk factors for the development of phlebitis (P<0.001). Catheter size, hospitalisation in the surgery ward and continuous infusion contributed to the development of infiltration. Age, hospitalisation in the surgery ward and catheter placement in the antecubital vein contributed to the development of phlebitis.

Incidence and Associated Factors of Failed First Peripheral Intravenous Catheters among Adult Patients at Medical Surgical Wards in Public Referral Hospitals of West Amhara, Ethiopia, 2021.

Background Complications of peripheral intravenous catheters cause problems in clinical practice and bring high costs in terms of morbidity and mortality of patients. Therefore, this study aimed to assess the incidence and associated factors of failed first peripheral intravenous catheters among adult patients in selected Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021. Materials and Methods An institution-based prospective observational study was conducted among 423 adult patients from January to February 2021. Patients were selected using systematic random sampling techniques. The data were collected using interviewer-based, structured questionnaires and observational checklists. EPI-DATA 3.1 and SPSS version-23 were used for data entry and analysis, respectively. Frequency, percentages, and means were calculated. The outcome variable was determined and graded based on phlebitis and infiltration scales. Binary and multivariable logistics regressions were computed. Results Four hundred and seventeen first peripheral cannula sites from 418 patients were followed for 2,565 peripheral catheter hours. A failed first peripheral intravenous catheter was observed in 124 (29.7%, CI: 25.6–34) adult patients. Patients who were female (AOR = 0.4, 95% CI: 0.22–0.74) had cannula duration of 49–72 hours (AOR = 0.31, 95% CI: 0.14–0.7) and 73–96 hours (AOR = 0.39, 95% CI: 0.17–0.9), and patients who had been given electrolytes (AOR = 0.31, 95% CI: 0.11–0.86) were more likely to have failed first peripheral intravenous cannula. Conclusions Failed first peripheral intravenous cannula is much higher as compared to the acceptable rate of ≤5% by the Infusion Nurses Society. Hence, all patients with peripheral intravenous catheters are screened for catheter failure at least once a day. Providing appropriate nursing care and patient education is also required to reduce the risks.

On a quest to prevent harm and safeguard paediatric venous catheters – A randomized control trial protocol

Aim: This study will evaluate the most effective peripheral intravenous catheter securement in paediatric emergency departments to reduce catheter failure, healthcare costs, patient distress, and improve satisfaction. Design: A multisite, three-arm, parallel, superiority, randomized controlled trial of 506 children requiring peripheral intravenous catheter in the emergency department. The trial will be reported following CONSORT guidelines, is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12619001026112) and ethics is approved via Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/45567). Methods: Staff screen patients, six months to eight years old, requiring peripheral intravenous catheters and inpatient stay of more than 24 hours. Written informed consent is obtained from the legal guardian with 1:1:1 randomization ratio allocation: 1. Standard care: Bordered polyurethane dressing (Tegaderm Advanced®; 3M) 2. Integrated dressing and securement: SorbaView SHIELD® (Centurion Medical Products) 3. Integrated dressing and securement with tissue adhesive: SorbaView SHIELD® (Centurion Medical Products) and Tissue Adhesive Secureport IVTM (Adhezion Biomedical) Primary outcome is peripheral intravenous catheter failure; secondary outcomes are peripheral intravenous catheter complications, pain and distress, healthcare costs, and staff satisfaction or acceptability. Intention-to-treat analysis of timeto-event data will be completed using adjusted Cox regression. Direct costs calculated from the hospital perspective and costeffectiveness analysis will estimate the incremental cost of each treatment option. Discussion: Most hospitalized children require a peripheral intravenous catheter, although persistent high rates of failure are recognized as a patient safety concern. The outcomes of this trial will directly inform clinical care for peripheral intravenous catheter securement in children in emergency departments. Charters1,2, RN, PG Paed Acute Care, Kelly Foster2 , MNRS, RN, Dip HS, PG Crit Care, PhD Candidate, Benjamin Lawton1 , BSc, MBCHB, FRACP, Mph, Corey Cassidy3 , BSc (Hons), MBBS (Hons), FACEM, Joshua Byrnes4 , BEcon, BComm, MEcon, MHealth Econ, PhD, Gabor Mihala4,5, MEng (Mech), Gcert (Biostat), PhD, Jessica Schults5-8, RN, PhD, Tricia Kleidon5,6,8, RN, MNSci (Nurse Prac.), PhD candidate, Ruth McCaffery3 , RN, Kristy Van9 , RN, MNrs, and Amanda Ullman5-8, RN, PhD

Correlation between visual inspection/physical exam and point-of-care ultrasound exam in the evaluation of neonatal peripheral intravenous catheter site

Background A peripheral intravenous catheter (PIVC) is used to administer IV fluids and medications. The most common PIVC complication is peripheral intravenous extravasation and infiltration (PIVE/I). Early visual inspection and physical exam (VI/PE) of the insertion site performed by a registered nurse (RN) are essential to prevent or limit tissue damage caused by displaced PIV catheters. Skin ultrasound (US) of the PIVC site provides rapid, real-time, high-resolution images of the anatomic structures at the point of care (POC). Objectives To correlate the standard practice of clinical assessment (VI/PE) with POC-US exam to determine the location and function of PIVC suspicious for malfunctioning. Design/Methods PIVC sites suspicious of malfunctioning were assessed by RN and findings were recorded in the electronic medical record. POC-US exam of the PIVC site was performed immediately after VI/PE. Sonographic exam included B-mode assessment of the PIVC site subcutaneous tissue characteristics and PIVC location as assessed by the Doppler flow tracing during RN’s normal saline flush. RN’s decision to continue or discontinue the PIVC was based solely on her/his VI/PE. Results Forty-four infants were studied. We found sufficient disagreement between the two methodologies (p = .0074), with discordance noted in 15 (34.1%) cases. In 29 (65.9%) cases there was concordance between VI/PE and POC-US, 18 to remove and 11 not to remove PIVC (Gwet AC1 correlation coefficient = 0.34). There was no significant correlation between VI/PE finding of tissue edema, the most common initial clinical evaluation sign, and POC-US finding of tissue edema or fluid pockets (p = .67, p = .21 respectively). RN’s findings during the PIVC flush with normal saline (NS) were in perfect agreement with the findings of the Doppler signal on POC-US (Gwet’s AC1 = 0.82) as well as with the final US-based decision to remove PIVC (p < .0001). Conclusion We found only a fair correlation between RN’s VI/PE of the suspicious PIVC site and the POC-US exam of the same site. However, our data suggest that in the evaluation of questionable PIVC, POC-US could be used in conjunction with VI/PE. This combination may improve the accuracy of decisions to remove or maintain PIVCs, which will result in a decreased number of PIVC placement attempts and complications.

Mothers’ knowledge regarding peripheral intravenous catheter caring and complications among pediatric patients: A cross-sectional study

Objective: Pediatric patients are considered at risk for Peripheral intravenous catheters (PIVCs) complications more than adults. This study aimed to assess the level of mothers’ knowledge of PIVC maintenance, caring, and complications among pediatric patients. It was also aimed to investigate the association between maintenance and complication knowledge of PIVC. Furthermore, demographic factors were investigated to assess associations on mothers’ knowledge of PIVC.Methods: The study adopted a cross-sectional design. This study was performed on a convenience sample of 193 mothers from a tertiary hospital in Jordan in 2020.Results: Mothers’ knowledge regarding complications was higher than their knowledge of maintenance and caring of PIVC. Mothers’ knowledge toward caring for PIVC was positively correlated with their knowledge about PIVC complications. Mothers’ age and the number of hospital admissions were found to be significantly associated with the level of maintenance and caring knowledge of PIVC but not with complication knowledge of PIVC. The higher the educational level of a mother the less prone she is to complications of PIVC in pediatric patients.Conclusions: It is recommended that health professionals working in pediatric engage mothers in educational sessions to improve maintenance, care, and to prevent complications of PIVC among pediatric patients.

Does non-invasive blood pressure measurement increase the complications and decrease indwelling time of peripheral intravenous catheters: A cohort study.

To explore the efficacy of non-invasive blood pressure monitors on reducing clinical complications of peripheral intravenous catheters in renal transplant recipients. A peripheral intravenous catheter is a regular route of medication administration, but the incidence of complications such as infiltration, occlusion and phlebitis perpetuates in the clinical setting. This was a cohort study. Patients were placed naturally into observation group or control group according to whether or not the two procedures (non-invasive blood pressure monitoring and peripheral intravenous catheters indwelling) were on the same arm. Univariate test and Cox regression model were used to estimate relative risk factors. The STROBE checklist was used to guide the submission. We identified 177 kidney recipient patients during the perioperative period with 440 peripheral intravenous catheters. There were incidences of 112 (25.5%) phlebitis, 137 (31.1%) occlusion and 150 (31.8%) infiltration. There was no significant difference between incidence of phlebitis, occlusion and infiltration between the observation group and the control group (p>.05). The observation group peripheral intravenous catheters indwelling time was 97.03±6.76hr, while it was 89.22±9.55hr for the control group. However, this difference was not significant between the two groups (p>.05). Cox risk regression showed that only a high BMI was a risk factor for peripheral intravenous catheters indwelling time. Non-invasive blood pressure monitoring did not increase complications or shorten PIVCs indwelling time among renal transplant recipients. BMI represented an independent risk factor for the peripheral intravenous catheters indwelling time. It is not a prohibition to take non-invasive blood pressure measurement when having a peripheral intravenous catheter, especially in some special circumstances in the clinical practice or when good prevention procedures are implemented.

Effects of a Clinically Indicated Peripheral Intravenous Replacement on Indwelling Time and Complications of Peripheral Intravenous Catheters in Pediatric Patients: A Randomized Controlled Trial.

Peripheral intravenous catheters (PVCs) are common treatment modalities for pediatric patients, and may cause infection, infiltration, occlusion, and phlebitis. The purpose of this study was to evaluate the effect of a clinically indicated peripheral intravenous replacement (CIPIR) on PVC indwelling time and complication rates in pediatric patients. This study used a randomized, pre- and post-repeated measures design. A total of 283 participants were randomly assigned to an experimental group (n = 140) and a control group (n = 143). The experimental group received CIPIR and the control group received usual care with routine PVC replacement every three days. The insert sites of PVC were assessed every day until the signs of infiltration, occlusion, or phlebitis were presented. Patients in the experimental group had significantly longer PVC indwelling times compared to those in the control group (t = −18.447, p < 0.001). No significant differences were noted between groups in infiltration (χ2 = 2.193, p = 0.139), occlusion (χ2 = 0.498, p = 0.481), or phlebitis (χ2 = 3.865, p = 0.050). CIPIR can prolong the PVC indwelling time in pediatric patients with no increase in the rate of adverse events.

The Occurrence of Peripheral Intravenous Catheter Complications and an Evaluation of the Methods Utilized to Mitigate Them

The Occurrence of Peripheral Intravenous Catheter Complications and an Evaluation of the Methods Utilized to Mitigate Them

Standard versUs peRForated (SURF) peripheral intravenous catheter trial: a pilot randomised controlled trial protocol

Introduction: Contrast-enhanced computed tomography (CECT) scanning requires a large bore peripheral intravenous catheter (PIVC) to support the high-flow injection of contrast needed to generate a quality image. Unfortunately, not all patients’ veins will tolerate high-flow injection and this can subsequently lead to complications, procedural delays, use of alternate intravascular access, and potential compromise of scan image. This study will evaluate the effectiveness of perforated catheters compared to standard catheters in reducing PIVC complications and failure during high-flow injection for CECT scans. Methods and analysis: This single-centre, parallel-group, pilot randomised controlled trial (RCT) will be undertaken to test the feasibility of conducting a larger trial comparing a PIVC with a novel perforated design to a standard (non-perforated) PIVC. The study will be conducted at the Royal Brisbane and Women’s Hospital, Australia, and the recruitment target is 60 (30 per group). There are two primary outcomes of interest to test: 1) Feasibility of an adequately powered RCT with pre-established criteria for eligibility, recruitment, protocol adherence and retention; and 2) All cause PIVC failure rate. Secondary outcomes to be collected include first insertion success, subtypes of PIVC failure, PIVC dwell time, contrast delivery, and CECT image quality. Adverse and serious adverse events (i.e., extravasation, allergic reaction to the contrast) also will be monitored. Feasibility outcomes will be reported descriptively and assessed against pre-determined acceptability criteria. Statistical comparison methods will be tested. Regression analysis will assess the effect of patient and treatment differences. Ethics and trial commencement: This pilot trial has ethical approval from Queensland Health (HREC/2019/QRBW/55616) and Queensland University of Technology (QUTHREC/1900001090).

Peripheral Intravenous Catheter Complications in Hospitalized Cats: An Observational Pilot Study

ObjectivesThere is little information about complications associated with peripheral catheter use in cats. The primary objective of this study was to determine the main reason for catheter removal in cats hospitalized in the Intensive Care Unit at a university teaching hospital. The secondary objective was to describe catheter-associated complications in cats hospitalized. MethodsAll feline patients with peripheral intravenous catheters admitted to the Intensive Care Unit between June and August 2017 were prospectively enrolled in this study. All catheters were evaluated at least 3 times a day per institutional Intensive Care Unit protocol. The catheters were monitored throughout the cat's hospitalization period for development of complications, including occlusion, phlebitis and extravasation. Data collected included patient signalment, reason for hospitalization, catheter size and location, number of hours the catheter remained in place, reason for removal and if the catheter was replaced once removed. ResultsThirty-four cats were enrolled in the study, and a total of 42 catheters were placed in those cats. Median peripheral IV catheter duration was 23.8 hours (interquartile range [IQR] 13.8-41.3 hours). The most frequent reason for catheter removal was patient discharge from the hospital (24/42, 57.1%). Overall catheter complication rate was 21.4% (9/42). Complications observed included phlebitis, extravasation, patient removal, occlusion, and edema formation. Clinical significanceThe results of this study conclude that the majority of peripheral IV catheters in cats are removed due to discharge from hospitalization. More studies with a larger population of cats are needed to see if there is a relationship between length of indwelling catheterization and risk of catheter-associated complications.

The Incidence of Peripheral Intravenous Catheter Phlebitis and Risk Factors among Pediatric Patients

BackgroundPhlebitis is one of the most common complications of peripheral intravenous catheter (PIVC) that can lead to many complications, including higher medical costs and longer hospital stays. ObjectiveTo identify the incidence of phlebitis associated with PIVC and determine its risk factors among hospitalized pediatric patients. MethodsAn observational and cross-sectional design was used. Data such as patient's demographics, medical diagnosis, place of admission, and other PIVC characteristics were recorded. In addition, observations of PIVC sites over 12-hour intervals were conducted to measure PIVC complications using the Visual Infusion Phlebitis (VIP) scale.Sample and Setting.Over a period of six months, a sample consisting of 307 children from five governmental hospitals that are located in north and middle Jordan were targeted. The sample consists of patients under 12 years old with PIVCs who were hospitalized in pediatric departments. ResultsPIVC catheterization has been associated with several complications such as phlebitis (N = 164; 53.4%), extravasation (N = 107, 34.9%), pain (N = 37; 12.1%), leakage (N = 37; 12.1%), and obstruction (N = 26; 8.5%). The main risk factors for phlebitis were: children admitted to wards, PIVC inserted by novice nurse, catheter inserted in the lower limbs, and catheter with contaminated dressing. ConclusionThis study enriches knowledge of PIVC complications and risk factors of phlebitis to help nurses avoid complications and initiate prompt treatment, leading to decrease financial burden as well as patient pain and discomfort.