The peripheral intravenous catheter (PIVC) is one of the world’s most frequently used medical devices, with an estimated annual volume of 2 billion units sold globally. This study aimed at acquiring a holistic understanding of publications investigating PIVC-related complications worldwide by conducting a literature review and preliminary data analysis. A systematic literature review, using key terminologies in the PubMed advanced search engine, was executed with timeframe set to 2005 onwards. Key articles outside the analytical framework were added by clinical experts in the Becton Dickinson (BD) catheter team. Complications examined in this review included catheter-related bloodstream infection (CRBSI), catheter-related infections, bacteremia, occlusion, thrombosis, phlebitis, infiltration, extravasation, and dislodgement. The initial review identified 13,251 articles written in English and 11 additional articles were contributed by the BD internal repository. 985 articles were excluded before full-text examination with key outcomes other than PIVC-related complications, and/or with nonhuman subjects. Ultimately, 84 articles met inclusion criteria with data available for extraction, while the remaining 12,277 did not. PIVC-related complication rate was described under three units: % of catheters, % of patients, and per 1,000 catheter days. Complication rate in the same unit were weighted with study sample size and reported as weighed averages and are as follows: CRBSI: 4.33%, catheter related infections: 4.12%, bacteremia: 9.32%, occlusion: 6.87%, thrombosis: 7.00%, phlebitis: 13.60%, infiltration: 31.49%, extravasation: 5.30%, and dislodgement: 5.70%. Outliers include the neonatal population and a healthcare facility inside a developing nation. Complication rates under % patients and per 1,000 catheter days also showed similar burden. Given the widespread use of PIVCs, magnitude and implications of PIVC-related complications might be understated. As use of PIVCs continues to increase due to aging populations and prevalence of chronic diseases, more in-depth analyses and real-world studies are needed to understand and confirm actual burden.
Read full abstract