Use Of Peripheral Intravenous Catheters Research Articles

Peripheral intravenous catheter insertion, maintenance and outcomes in Indonesian paediatric hospital settings: A point prevalence study

PurposeThis study aimed to assess peripheral intravenous catheter use, maintenance practices, and outcomes of paediatric patients in a developing country setting. Design and methodsA point prevalence survey using validated checklist was conducted between March and April 2022 in ten hospitals in Indonesia. A total number of 478 participants were approached during the audit. Data were obtained from site observation and medical records. ResultsOf the 386 patients surveyed, >90% (362) had one catheter in-situ. The catheters were mostly inserted by nurses (331, 86%), primarily in the dorsum of the hand (207, 54%) with the purpose of delivering intravenous infusions and medications (367, 95%). Simple transparent dressings (176, 46%) with splint and bandage (295, 76%) were predominantly used for securement methods. Insertion sites were not visible for 182 (47%) patients, and 151 (40%) of daily care practices were poorly documented. Complications were documented in the medical record for 166 (43%) catheters. Adjusted analysis indicated that patient diagnosis, ward, catheter size, location, dressings, infusate, and flushing administration were significantly associated with complications. ConclusionsFindings indicate that issues related to paediatric intravenous catheter complications in Indonesia are comparable to developed country settings. Ongoing surveillance is important to evaluate the management practices to benchmark against guidelines, optimise patient safety, and improve outcomes. Practice implicationsResults demonstrate low and middle-income countries face similar challenges with catheter insertion and care. The study indicates the importance of applying vascular access needs assessments, providing training for inserters, identifying optimum dressing methods, and optimising documentation.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study

Aimto compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BackgroundThe use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DesignA randomized simulation experimental pre-post interventional study. MethodsSixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. ResultsPerformance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. ConclusionsThe rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses’ performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

PREVALENCE OF PHLEBITIS AMONG PATIENTS RECEIVING PERIPHERAL INTRAVENOUS THERAPY IN A TERTIARY CARE HOSPITAL IN INDIA

Background: Phlebitis is a common complication associated with the use of peripheral intravenous catheters. Main uses of a peripheral intravenous catheter are infusions, blood sampling, administration of parenteral medications and blood products. It is one of the commonly performed procedure in hospital. Almost all of hospital admissions lead to intravenous catheter placement. Aim:To assess the prevalence of phlebitis among patients on peripheral intravenous catheter and identify predisposing factors of phlebitis in patients. Methodology: 398adult patients in wards, with Peripheral intravenous catheter (PIVC) were included in the study during a period of 4 months. Catheter insertion site of these patients were observed for signs of phlebitis using Visual Infusion Phlebitis scale, until discharge or until the resite of next catheter. The data collection and analysis included patient demographic details and data related to catheter (including number of attempts during insertion, experience of staff performing the cannulation, reasons for removal etc.), as well as the data on the type of administered medications and intravenous therapy. Results:A total of 398 patients were enrolled, among which 228 were males and 170 were females. A total of 192 patients (48.24%) showed one or other early signs of phlebitis. Among these 192 patients with early signs of phlebitis, 128 patients (66.67%) had score 1 in VIP scale while 64 patients (20.47%) had score 2 and 3.Phlebitis was found to be associated with mobility status of the patients (&lt;0.001). Conclusion:This study showed a high prevalence of phlebitis among inpatients in wards. However, most of these cases were mild Grade 1 phlebitis.Its crucial to train and upskill staffs on PIVC insertion and monitoring to ensure proper placement and assessment. Daily assessment of insertion site and need for PIVC and patient awareness on PIVC maintenance is crucial in prevention of phlebitis.

Best practice in the use of peripheral venous catheters: A scoping review and expert consensus

Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also occur. Even if PIVC-related infections are rare, the total number of affected patients and the preponderance of Staphylococcus aureus as related pathogen due to the frequent use of these devices are relevant arguments to implement preventive strategies. The aim of this document is to raise awareness that infections caused by PIVCs are a relevant problem that can be reduced by practice change. A panel of experts discussed this topic based on evidence and proposed practice points by consensus. Despite published evidence-based guidelines, current practice concerning aseptic techniques during insertion and care of PIVCs often are substandard. These devices have become commonplace and tend to be perceived as safe. An overall lack of awareness about the true risks associated with the use of PIVCs results in limited surveillance and prevention efforts. Successful insertion and maintenance bundles in central venous lines are a blueprint to the implementation of adapted bundle strategies in the prevention of PIVC-associated infections. There is a need for studies to specifically investigate infection prevention in PIVCs and to agree on effective and implementable bundles.

Safety verification of a new peripheral intravenous catheter placed in the upper arm vein for administration of drugs with high irritant potential.

Despite the widespread use of peripheral intravenous catheters, unscheduled catheter failure before completion of treatment occurs frequently. If a large vein is selected, catheter failures may be prevented despite administering a highly irritant drug. In this study, we attempted to use a catheter that can be placed in a large upper arm vein. The new catheter was 88 mm long but had no guidewire to reduce contamination risk. This study aimed to evaluate the safety of the first-in-human trial for the new catheter with the administration of highly irritant drugs. This study was conducted at a university hospital in Tokyo, Japan. Eight Japanese adults were hospitalized adults with planned administration of non-cancer drugs with high irritant potential using a peripheral catheter. A trained nurse catheterized with the new catheter in the upper arm using ultrasonography. The catheterization site was monitored by staff and a research nurse once every 24 hours for up to 7 days. No adverse events or catheter failure occurred and the catheter placement success rate was 100%. In two patients, a temporary occlusion alarm of the infusion pump occurred, possibly due to the flexion of the catheter base. The new peripheral intravenous catheter did not interrupt medical treatments as is common after placement, but safety administered the irritant drugs. However, because this catheter may be easily affected by the contraction of the muscle at the fixation position, the position and method of catheter fixation in the upper arm need to be carefully considered.

Quality of care for peripheral intravenous catheters (PIVCs) in Nepal: a cross-sectional study on feasibility and inter-rater agreement of the Peripheral Intravenous Catheters-mini Questionnaire (PIVC-miniQ) in a tertiary care hospital

ObjectivesThere is a lack of data regarding the quality of peripheral intravenous catheter (PIVC)-related care from low-income and middle-income countries, even though the use of PIVCs may lead to local...

Long peripheral catheters and midline catheters: Insights from a survey of vascular access specialists.

Peripheral intravenous access is no longer limited to the standard intravenous catheter (cannula). Devices varying in length, material and insertion technique, are increasingly accessible. There is substantial variability surrounding the nomenclature and use of these devices in the literature. We wished to understand the attitude of vascular access specialists towards the nomenclature and use of peripheral intravenous catheters (PIVCs), long peripheral catheters (LPCs) and midline catheters (MCs). A 15-question electronic survey was sent to members of the Association of Vascular Access (AVA) regarding the nomenclature and use of PIVCs, LPCs and MCs. A total of 228 participants completed the survey. Approximately two-thirds of respondents use LPCs (65.8%) and MCs (71.9%) in their clinical practice. The most common indication for LPCs was difficult venous access (56.5%), while the most common indication for MCs was medium-term (1-4 weeks) intravenous therapy (62.7%). The majority of participants (57.9%) agreed with the following classification of peripheral intravenous devices:PIVCs: 2 to 6 cm in length, terminating distal to the axilla;LPCs: 6 to 15 cm in length, terminating distal to the axilla;MCs: 15-25 cm in length, terminating in the axilla.Participants suggested that the length of the catheter should be considered a general recommendation, as LPCs and MCs should be primarily differentiated by tip location. The majority of vascular access specialists from AVA have incorporated LPCs and MCs into their repertoire of peripheral venous access tools. We envisage that their use will increase as the clinical community becomes more familiar with these devices.

Prevalence and risk factors of inappropriate use of intravenous and urinary catheters in surgical and medical patients

Previously, the RICAT (Reduction of Inappropriate use of intravenous and urinary CATheters) study had been conducted by ourselves to reduce inappropriate use of intravenous and urinary catheters in medical wards to prevent healthcare-associated infections. To compare surgical and medical wards, and to determine risk factors for inappropriate catheter use. A cross-sectional study was performed from October, 2017, to May, 2018, in surgical wards of two university hospitals in the Netherlands. Patients were prospectively observed every other week for seven months. Inappropriate use was compared with non-surgical wards in the RICAT study. In all, 409 surgical patients were included, and they were compared with 1781 medical patients. Inappropriate use occurred in 36 (8.5%) out of 425 peripheral intravenous catheters in 373 surgical patients, compared to 400 (22.9%) out of 1747 peripheral intravenous catheters in 1665 medical patients, a difference of 14.4% (95% confidence interval (CI): 11.1-17.8; P < 0.001). Inappropriate use of urinary catheters occurred in 14 (10.4%) out of 134 surgical patients, compared to 105 (32.4%) out of 324 medical patients, a difference of 22.0% (95% CI: 14.7-29.2; P < 0.001). Subgroup analysis in the two university hospitals confirmed these differences. The main risk factor for inappropriate use of peripheral intravenous catheters was admission in medical wards (odds ratio (OR): 3.50; 95% CI: 2.15-5.69), which was also one of the main risk factors for urinary catheters (OR: 2.75; 95% CI: 1.36-5.55). Inappropriate use of catheters is more common in medical wards compared to surgical wards. Prevention strategies to reduce healthcare-associated infections should primarily focus on sites with high prevalence of inappropriate use.

De-implementation strategy to reduce inappropriate use of intravenous and urinary catheters (RICAT): a multicentre, prospective, interrupted time-series and before and after study

Catheter-associated bloodstream infections and urinary tract infections are frequently encountered health care-associated infections. We aimed to reduce inappropriate use of catheters to reduce health care-associated infections. In this multicentre, interrupted time-series and before and after study, we introduced a de-implementation strategy with multifaceted interventions in seven hospitals in the Netherlands. Adult patients admitted to internal medicine, gastroenterology, geriatic, oncology, or pulmonology wards, and non-surgical acute admission units, and who had a (central or peripheral) venous or urinary catheter were eligible for inclusion. One of the interventions was that nurses in the participating wards attended educational meetings on appropriate catheter use. Data on catheter use were collected every 2 weeks by the primary research physician during the baseline period (7 months) and intervention period (7 months), which were separated by a 5 month transition period. The primary outcomes were percentages of short peripheral intravenous catheters and urinary catheters used inappropriately on the days of data collection. Indications for catheter use were based on international guidelines. This study is registered with Netherlands Trial Register, NL5438. Between Sept 1, 2016, and April 1, 2018, we screened 6157 patients for inclusion, of whom 5696 were enrolled: 2650 patients in the baseline group, and 3046 in the intervention group. Inappropriate use of peripheral intravenous catheters occurred in 366 (22·0%, 95% CI 20·0 to 24·0) of 1665 patients in the baseline group and in 275 (14·4%, 12·8 to 16·0) of 1912 patients in the intervention group (incidence rate ratio [IRR] 0·65, 95% CI 0·56 to 0·77, p<0·0001). Time-series analyses showed an absolute reduction in inappropriate use of peripheral intravenous catheters from baseline to intervention periods of 6·65% (95% CI 2·47 to 10·82, p=0·011). Inappropriate use of urinary catheters occurred in 105 (32·4%, 95% CI 27·3 to 37·8) of 324 patients in the baseline group compared with 96 (24·1%, 20·0 to 28·6) of 398 patients in the intervention group (IRR 0·74, 95% CI 0·56 to 0·98, p=0·013). Time-series analyses showed an absolute reduction in inappropriate use of urinary catheters of 6·34% (95% CI -12·46 to 25·13, p=0·524). Our de-implementation strategy reduced inappropriate use of short peripheral intravenous catheters in patients who were not in the intensive care unit. The reduction of inappropriate use of urinary catheters was substantial, yet not statistically significant in time-series analysis due to a small sample size. The strategy appears well suited for broad-scale implementation to reduce health care-associated infections. Netherlands Organisation for Health Research and Development.

Risk Factors for Phlebitis in Patients with Peripheral Intravenous Catheters

Introduction: The study investigated the risk factors of phlebitis associated with infusion by peripheral intravenous catheter (PIVC).&#x0D; &#x0D; Methodology: Hospitalized adults (n = 506) were placed with PIVCs by trained nurses. Rates of phlebitis were noted according to PIVC gauge, insertion site, and dwell time; and type and volume of infusion solution.&#x0D; &#x0D; Results: The development of phlebitis appeared to be significantly associated with the size of the outer diameter of the PIVC. The rate of phlebitis among patients given a hypertonic infusion solution was significantly higher; and also associated with infusion volume. There was no difference in phlebitis development among insertion sites, and dwell times among these sites were comparable.&#x0D; &#x0D; Conclusion: The risk of phlebitis increased with the PIVC size and volume of infusion solution, and use of a hypertonic solution. The recognition of risk factors and standardized intervention may reduce the occurrence of phlebitis associated with PIVC use.

The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis.

Phlebitis is a common complication associated with the use of peripheral intravenous catheters. The aim of this study was to estimate the incidence of phlebitis with peripheral intravenous catheter use and to identify risk factors for phlebitis development. Literature survey was conducted in electronic databases (CINAHL, Embase, Google Scholar, Ovid, and PubMed), and studies were included if they used peripheral intravenous catheter for therapeutic or volumetric infusion and reported phlebitis incidence rates. Random effects meta-analyses were performed to obtain overall and subgroup phlebitis incidence rates and odds ratio between males and females in phlebitis incidence. Thirty-five studies were included (20,697 catheters used for 15,791 patients; age 57.1 years (95% confidence interval: 55.0, 59.2); 53.9% males (95% confidence interval: 42.3, 65.5)). Incidence of phlebitis was 30.7 per 100 catheters (95% confidence interval: 27.2, 34.2). Incidence of severe phlebitis was 3.6% (95% confidence interval: 2.7%, 4.6%). Incidence of phlebitis was higher in non-intervened (30% (95% confidence interval: 27%, 33%)) than in intervened (21% (95% confidence interval: 15%, 27%)) groups, and with Teflon (33% (95% confidence interval: 25%, 41%)) than Vialon (27% (95% confidence interval: 21%, 32%)) cannula use. Odds of developing phlebitis was significantly higher in females (odds ratio = 1.42 (95% confidence interval: 1.05, 1.93); p = 0.02). Longer dwelling time, antibiotics infusion, female gender, forearm insertion, infectious disease, and Teflon catheter are important risk factors for phlebitis development identified by the included studies. Incidence of phlebitis with the use of peripheral intravenous catheters during infusion is 31%. Severe phlebitis develops in 4% of all patients. Risk of phlebitis development can be reduced by adapting appropriate interventions.

Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide.

Peripheral intravenous catheter (PIVC) use in health care is common worldwide. Failure of PIVCs is also common, resulting in premature removal and replacement. To investigate the characteristics, management practices, and outcomes of PIVCs internationally. Cross-sectional study. Hospitalized patients from rural, regional, and metropolitan areas internationally. Hospital, device, and inserter characteristics were collected along with assessment of the catheter insertion site. PIVC use in different geographic regions was compared. We reviewed 40,620 PIVCs in 51 countries. PIVCs were used primarily for intravenous medication (n = 28,571, 70%) and predominantly inserted in general wards (n = 22,167, 55%). Two-thirds of all devices were placed in non-recommended sites such as the hand, wrist, or antecubital veins. Nurses inserted most PIVCs (n = 28,575, 71%); although there was wide regional variation (26% to 97%). The prevalence of iIn this study, we found that many PIVCs were placed in areas of flexion, were symptomatic or idle, had suboptimal dressings, or lacked adequate documentation. This suggests inconsistency between recommended management guidelines for PIVCs and current practice.dle PIVCs was 14% (n = 5,796). Overall, 10% (n = 4,204) of PIVCs were painful to the patient or otherwise symptomatic of phlebitis; a further 10% (n = 3,879) had signs of PIVC malfunction; and 21% of PIVC dressings were suboptimal (n = 8,507). Over one-third of PIVCs (n = 14,787, 36%) had no documented daily site assessment and half (n = 19,768, 49%) had no documented date and time of insertion. In this study, we found that many PIVCs were placed in areas of flexion, were symptomatic or idle, had suboptimal dressings, or lacked adequate documentation. This suggests inconsistency between recommended management guidelines for PIVCs and current practice.

International prevalence of the use of peripheral intravenous catheters.

Over a billion peripheral intravenous catheters (PIVCs) are inserted each year in hospitalized patients worldwide. However, international data on prevalence and management of these devices are lacking. The study assessed the prevalence of PIVCs and their management practices across different regions of the world. This global audit involved 14 hospitals across 13 countries, with 479 patients screened for the presence of a PIVC. We found 59% of patients had at least 1 PIVC in place, and 16% had other types of vascular devices. We also found that overall, 25% of patients had no vascular device in place. The majority of PIVCs were inserted by nursing staff or a specialist team. The prevalence of idle PIVCs in place with no fluid or medication orders was 16%, and 12% of PIVCs had at least 1 symptom of phlebitis.

Heparin for prolonging peripheral intravenous catheter use in neonates: a randomized controlled trial.

To determine the efficacy of heparinized saline administered as intermittent flush on functional duration of the peripheral intravenous catheter (PIVC) in neonates. Randomized, double-blind and placebo-controlled trial. Neonatal intensive care unit of a teaching hospital. Term and preterm neonates born at >32 weeks of gestation who required PIVC only for intermittent administration of antibiotics. Eligible neonates were randomized to receive 1 ml of either heparinized saline (10 U ml(-1)) (n=60) or normal saline (n=60) every 12 h before and after intravenous antibiotics. Functional duration of first peripheral intravenous catheter. A total of 120 neonates were randomized to two groups of 60 neonates each. The mean (s.d.) of age of babies in case and control group was 5.7 (2.5) days and 4.6 (3.1) days, respectively. The average weight of babies in both the groups was 2.1 kg. Mean functional duration of first catheter was more in heparinized saline group, mean (s.d.) of 71.68 h (27.3) as compared with 57.7 h (23.6) in normal saline group (P<0.005). The mean (95% confidence interval) difference in functional duration in the two groups was 13.9 h (4.7-23.15). Mean duration of patency for any catheter was also significantly more in heparinized saline group than control group. Heparinized saline flush increases the functional duration of peripheral intravenous catheter.

Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

Peripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

Duration of peripheral intravenous catheter use and development of phlebitis

Background Phlebitis is a common complication in patients withperipheral intravenous catheters, in addition to extravasation andbacterial colonization. Phlebitis may increase morbidity and lengthof hospitalization. One factor contributing to the rate of phlebitis isthe duration of peripheral intravenous catheter use. Several adultstudies have shown that the risk of developing phlebitis increasedwhen the peripheral intravenous catheter was used for more than72 hours. However, in pediatric patients this risk has not beenconsistently observed. As such, there is no recommendation forroutine catheter removal every 72 hours in children.Objective To assess for a possible relationship between durationof peripheral intravenous catheter use and the development ofphlebitis.Methods This analytic observational study had a case controldesign. Subjects consisted of 73 case subjects and 73 controlsubjects. We collected subj ects' data through history-taking andclinical examinations. The duration of peripheral intravenouscatheter use was reported in hours.Results From October 2011 to February 2012, 146 children fromthe Department of Child Health at Dr. Cipto MangunkusumoHosp ital and Tangerang Hospital who used peripheral intravenouscatheters were enrolled in this study. There was no significantdifference between &lt;7 2-hour and 2: 72-hour duration ofperipheral catheter use (OR 1.31; 95%CI 0.687 to 2.526;P= 0.407) on the development of phlebitis.Conclusion We observe no relationship between duration ofperipheral intravenous catheter use and the development ofphlebitis in our subjects.

Duration of peripheral intravenous catheter use and development of phlebitis

Duration of peripheral intravenous catheter use and development of phlebitis

Adverse events related to the use of peripheral intravenous catheters in children according to dressing regimens

A randomized, controlled study was implemented to verify reasons to release and adverse events related to the use of peripheral intravenous catheters in children, according to the dressing regimens The sample was set at 150 peripheral intravenous catheters, randomly assigned to three groups: sterile gauze dressings, sterilized transparent film dressings, and non sterile hypoallergenic adhesive tape. The data was collected after consent had been obtained by the Ethics Committee, including children who had been submitted to catheterization with Teflon(R) over the needle catheters. Statistical tests were performed by applying the Pearson Chi-square test, significance level set at p < 0.05. The results showed that dressing regimens influenced the reasons for catheter removal and occurrence of adverse events, mainly due to infiltration (55.3%). The Sterile gauze showed the best performance (p=0.002) in comparison with the other studied groups, once 40.0% of the catheters were removed by release from treatment.

Peripheral intravenous catheter use in Europe: towards the use of safety devices

Peripheral intravenous catheters are among the most widely used medical devices in the world. European patients are increasingly aware of the risk of health care associated infections and the role catheters play in their facilitation. We intend to show that European health care providers are increasingly aware of the occupational risks of bloodborne infections such as HIV and hepatitis which can be transmitted by the needles from catheters and that the political will is building to take action to ensure safer devices are provided. We review the wide variety of peripheral intravenous catheters which are specially engineered to reduce these risks. Available safety devices include spring-loaded retractable needles, guards that shield the dangerous tips and closed, needle-free access valves for intravenous sets. It is no longer necessary for patients and professionals to take risks to health and life when solutions which minimize these risks are at hand.

Thrombophilia in short peripheral catheter thrombophlebitis

Short peripheral catheter thrombophlebitis (SPCT), which is characterized by pain, erythema, swelling, and palpable thrombosis of the cannulated vein, is an important complication of peripheral intravenous catheter use [ [1] Tagalakis V. Kahn S.R. Libman M. Blostein M. (2002) The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med. 2003; 113: 146-151 Abstract Full Text Full Text PDF Scopus (189) Google Scholar ]. While the pathogenesis of SPCT is not well understood, one postulated mechanism is that vein wall injury, stasis, and inflammation lead to thrombus formation [ [2] Lewis G.B.H. Hecker J.F. Infusion thrombophlebitis. Br J Anaesth. 1985; 57: 220-233 Crossref PubMed Scopus (99) Google Scholar ]. Catheter-related risk factors for SPCT such as type of catheter material have been well elucidated and are thought to act via vein wall injury. Patient-related risk factors for SPCT are likely to be important as well, as there is evidence that individuals vary in biologic vulnerability to developing SPCT. For example, patients who developed SPCT with a first catheter are 50% more likely to develop SPCT with a subsequent catheter [ [3] Maki D.G. Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Ann Intern Med. 1991; 114: 845-854 Crossref PubMed Scopus (411) Google Scholar ]. However, determinants of patient-related risk factors are largely unknown. To improve understanding of the causes of the biologic vulnerability to SPCT development, we hypothesized that SPCT may be associated with underlying hypercoagulability related to thrombophilia. In recent years, studies have reported associations between thrombophilic disorders, including factor V Leiden, and prothrombin G20210A, and central venous catheter-related thrombosis [ 4 Nowak-Gottl U. Dubbers A. Kececioglu D. Koch H.G. Kotthoff S. Runde J. et al. Factor V Leiden, protein C, and lipoprotein (a) in catheter-related thrombosis in childhood: a prospective study. J Pediatr. 1997; 131: 608-612 Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar , 5 Knofler R. Siegert E. Lauterbach I. Taut-Sack H. Siegert G. Gehrisch S. et al. Clinical importance of prothrombotic risk factors in pediatric patients with malignancy-impact of central venous lines. Eur J Pediatr. 1999; 158: S147-S150 Crossref PubMed Google Scholar , 6 Fijnheer R. Paijmans B. Verdonck L.F. Nieuwenhuis H.K. Roest M. Dekker A.W. Factor V Leiden in central venous catheter-associated thrombosis. Br J Haematol. 2002; 118: 267-270 Crossref PubMed Scopus (64) Google Scholar , 7 Mandalà M. Curigliano G. Bucciarelli P. Ferretti G. Mannucci P.M. Colleoni M. et al. Factor V Leiden and G20210A prothrombin mutation and the risk of subclavian vein thrombosis in patients with breast cancer and a central venous catheter. Ann Oncol. 2004; 15: 590-593 Crossref PubMed Scopus (59) Google Scholar , 8 van Rooden C.J. Rosendaal F.R. Meinders A.E. van Oostayen J.A. van der Meer F.J.M. Huisman M.V. The contribution of factor V Leiden and prothrombin G20210A mutation to risk of central venous catheter-related thrombosis. Haematologica. 2004; 89: 201-206 PubMed Google Scholar , 9 Tesselaar M.E.T. Ouwerkerk J. Nooy M.A. Rosendaal F.R. Osanto S. Risk factors for catheter-related thrombosis in cancer patients. Eur J Cancer. 2004; 40: 2253-2259 Abstract Full Text Full Text PDF PubMed Scopus (92) Google Scholar ]. However, the role of thrombophilia in SPCT has not previously been examined.