Vascular Access Conversation - IVUPDATE Podcast from IVTEAM

"To determine the incidence and risk factors for adverse events using a transparent bordered dressing for securement in the dorsum of the hand or cubital fossa in consecutive patients hospitalized in an internal medicine department" Shimoni et al (2022).

Peripheral intravenous catheter outcomes

Abstract:

Background: In elderly patients hospitalized in internal medicine departments, risk factors, preferable placement area and methods of securement of short peripheral venous catheters (SPVC) is unclear.

Aim: To determine the incidence and risk factors for adverse events using a transparent bordered dressing for securement in the dorsum of the hand or cubital fossa in consecutive patients hospitalized in an internal medicine department.

Methods: In a prospective observational study of patients admitted to a regional hospital with a SPVC the dependent variable was the need to replace the catheter because of an adverse event (phlebitis, accidental removal, infiltration/occlusion). The independent variables were age, gender, disorientation, placement area, intravenous antibiotic therapy and the indwelling time. Risk factors were determined by Cox regression model analysis.

Results: There were 709 catheters placed in 499 patients. Per catheter placed the mean age was 75± 17 years. Accidental removal, infiltration/obstruction and phlebitis occurred in 21.5, 16.2 and 15.0 events per 1000 days respectively. There was a significantly increased risk on day three compared to day two and four. An older age, intravenous antibiotics and disorientation increased the hazard for accidental displacement, whereas phlebitis was associated only with intravenous antibiotics and occlusion/infiltration only with age.

Conclusions: The observed low rates of adverse suggests that placement in the dorsum of the hand or cubital fossa secured by a transparent dressing is acceptable. It is important to consider the indwelling catheter time when studying adverse events and elderly patients, disoriented, and/or receiving intravenous antibiotics deserve special attention.


Reference:

Shimoni Z, Houdhoud N, Isaacs Y, Froom P. Observational Study of Peripheral Intravenous Catheter Outcomes in An Internal Medicine Department. Intern Med J. 2022 Nov 8. doi: 10.1111/imj.15963. Epub ahead of print. PMID: 36346286.