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Predicting factors for complications in peripheral intravenous catheters

"To characterize the association between peripheral intravenous catheter (PIVC) gauge (G), the patient's age, insertion site, and complication incidence" Resnick et al (2020).

Abstract:

Aim: To characterize the association between peripheral intravenous catheter (PIVC) gauge (G), the patient’s age, insertion site, and complication incidence.

Methods: This prospective study was performed in Hadassah Medical Center, Jerusalem, Israel, between June 2018 and March 2019. Children with PIVC admitted to the pediatric departments were included. PIVCs were evaluated daily.

Results: A total of 113 children with 132 PIVCs were included in the study. The most common site of insertion was the antecubital fossa (43.9%). PIVCs were most commonly used for intravenous (IV) antibiotics (46.6%). Complications were observed for 40.9% PIVCs. Dislodgement was the most common complication. The complication rate was higher for the lower limbs (60%), and external jugular veins (100%) p=0.002. In infants younger than 12 months, the complication rate was higher for 22G PIVCs or larger (58.7% versus 27.5%; p=0.05). In contrast, for the 1-6 years age group, PIVCs smaller than 24G had a higher complication rate (p=0.004). Patients with comorbidities had a higher complication rate (p=0.003).

Conclusion: Risk factors for complications are comorbidities and sites of insertion other than the upper limbs. In infants, 24G PIVC or smaller should be inserted, whereas 22G PIVC or larger are superior for 1-6 years old children.

Reference:

Resnick O, Abu Ahmad W, Bancovsky D, Rogachev S, Ashash A, Ohana Sarna Cahan L, Rekhtman D, Hashavya S, Gross I. Pediatrics predicting factors for complications in peripheral intravenous catheters. Acta Paediatr. 2020 Nov 23. doi: 10.1111/apa.15687. Epub ahead of print. PMID: 33226669.