Evaluation of unmodifiable and potentially modifiable factors affecting peripheral intravenous device-related complications in neonates: a retrospective observational study

Rens, Matheus F. P. T. van; Hugill, Kevin; Mahmah, Mohamad Adnan; Bayoumi, Mohammad A A; Francia, A; Garcia, Krisha L P; Loon, Fredericus H. J. van

doi:10.1136/bmjopen-2020-047788

Cited by 20 publications

(31 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To obtain vascular access during hospitalisation, PIVCs are often sourced as the primary and most inserted devices. [5] The incidence of PIVC therapy failure from this study demonstrates a slightly higher rate when compared with the pooled rates of failure (34%) in a recently published meta-analyses. [33] However, the incidence parallels other recently published unit-based research.…”

Section: Discussionmentioning

confidence: 44%

“…While this study provides recent clinical evidence on various risks of therapy failure with intravenous devices in neonates, it has also been reported in previous publications. [2,5,33] To the best of the authors knowledge, a study of this sample size including both peripheral and central catheters, with focus on device-related failures in neonates, has not been previously published.…”

Section: Discussionmentioning

confidence: 99%

“…[33] However, the incidence parallels other recently published unit-based research. [5] It is di cult to give an unambiguous clari cation for this, although the pattern of complications and their relative incidences do correlate.…”

Section: Discussionmentioning

confidence: 99%

“…However, VAD use is not without signi cant risks, with complications such as infections, thrombosis, device occlusion and peripheral intravenous in ltration/extravasation (PIVIE) frequently resulting in device failures and a potential but signi cant patient harm or injury. [3] Observational studies have found peripheral IV related complications as high as 75% [4,5], and 0.05-3% of central catheters in neonates resulted in therapy-related complications and device failure. [6,7] Preterm and sick neonates have an increased risk of complications, primarily due to an immature immune system, underdeveloped skin barrier, smaller, fragile blood vessels and exposure to invasive diagnostic and therapeutic procedures.…”

Section: Introductionmentioning

confidence: 99%

“…[15,16,17] Currently, PIVCs are most frequently used to provide infusion therapy. [5,18,19,20] It seems a presumption of high rates of central line-associated bloodstream infections (CLABSI) plays a signi cant role in making the, often inappropriate, choice of VADs. Comparison studies between CLABSI and peripheral line-associated bloodstream serious infections (PLABSI) are limited [16,17,21,22,23] and do not indicate any preference to either PIVC or PICC.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The ABBA project (Assess Better Before Access): a retrospective, cross-sectional study of neonatal intravascular device outcomes

Rens

Bayoumi

Hoogen

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Vascular access devices (VADs) play a vital role within the neonatal intensive care unit (NICU). However, VAD-use is not without significant risks, with complications such as infection, thrombosis, device occlusion and infiltration/extravasation frequently contributing to device-related failures and increase the risk of significant patient harm or injury. Methods: A retrospective, cross-sectional, single-center study in a large 112-bed NICU in Qatar that routinely collected intravenous device data from January 2016 to December 2018 was evaluated. The outcome of interest was to identify and evaluate the relationships between unmodifiable and potentially modifiable factors and Assess the situation and patients Better Before initiating vascular Access (ABBA), potentially reducing unwarranted complication rates leading to therapy failure within the neonatal setting.Results: During the study period, 23858 VADs were inserted. Of these, 89.3% were peripheral intravenous catheters (PIVCs). Infants who received a peripheral device were slightly older, with a median age of 8 (5) days, when compared to all infants receiving a central device, with a median age of 6 (4) days. Univariate logistic regression analyses identified 10 variables demonstrating significant relationships to device-related outcomes.Conclusions: Four subgroups of VAD were identified (peripheral intravenous catheters, extended dwell-peripheral intravenous devices, peripherally inserted central catheters and umbilical venous catheters). Central vascular access (peripherally inserted central catheters and umbilical venous catheters) had the least reported complications. Future research toward improving patient and intravenous therapy-related outcomes plays an important role. It requires a focus on innovations and clinical advancements in the world of neonatology and vascular access devices.

show abstract

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The ABBA project (Assess Better Before Access): a retrospective, cross-sectional study of neonatal intravascular device outcomes

Rens

Bayoumi

Hoogen

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Use of tissue adhesive for neonatal intravenous access devices: A scoping review

de Souza,

Takashima,

Silva

et al. 2024

Eur J Pediatr

View full text Add to dashboard Cite

Neonates often require vascular access devices for medication or fluid therapy, but a third of devices fail before treatment completion or end with a complication. For adults and children, securing these devices with tissue adhesive (TA) increases the dwell and reduces complications. However, there is a lack of evidence for the neonatal population. This scoping review aimed to assess the evidence of TA for vascular access devices in neonates. The Arksey and O’Malley’s (2005) framework was used. The inclusion criteria covered studies published from 2007 (when TA was first reported for use in vascular access devices) to June 2024, available in English, Portuguese, and Spanish, across six databases. Two independent reviewers assessed the studies using Covidence software, with a third reviewer resolving conflicts. Quality assessment was performed using the Mixed Methods Appraisal Tool. From 981 identified studies, 12 were included. Most studies (n = 5, 41.7%) enrolled between 100 and 500 neonates with vascular access devices. Publications originated from four regions and were observational studies (n = 6, 50%), quasi-experimental (n = 3, 25%), and case series (n = 2, 16.7%) with one randomized controlled trial (8.3%) focusing on umbilical venous catheters (UVC). The most common TA composition used was a combination of n-butyl- and 2-octyl- cyanoacrylate (n = 4, 33.3%). The amount of TA applied varied across studies, and often TA was part of a bundle (n = 7, 58.3%). Most studies applied TA to central venous access devices (n = 10, 83.3%) and 2 (16.7%) in peripheral devices. Although there was variation in device failure, the studies generally indicated a reduction in complications such as dislodgment (central catheter: 11.3% [peripherally inserted central catheter {PICC}] to 24.6% [UVC] in non-TA group vs 0.7% [PICC] to 7.7% [UVC] in TA group), device-associated bloodstream infections (central: 7.7% [UVC] and incidence of 2.76/1000 catheter days [PICC] in non-TA group vs 3.1% [UVC] and incidence of 0.99/1000 catheter day [PICC] in TA group), and phlebitis (13% in non-TA group vs 3% in TA-group), as well as increased dwell time in peripheral catheters. Most studies included both term and preterm neonates but did not differentiate between them in their analyses. Skin assessment, life of first dressing, and follow-up of catheters and patients were not reported in most studies. Conclusion: TA may reduce complications in vascular access devices, but the evidence in neonates is limited and varied. Many studies include TA as part of bundle, making it difficult to isolate its effects. Additionally, the current evidence lacks robustness due to the design limitations of the studies. Future research should focus on randomized controlled trials to evaluate TA’s effectiveness and safety in preventing device failures and complications in neonates, considering different subgroups, to ensure the safety of TA in these nuanced populations. What is Known:• Research in adults and pediatrics provides evidence supporting the use of tissue adhesive (TA) for vascular access devices, showing a positive impact in reducing failures and complications.• The use of TA in neonates needs to be carefully considered due to their unique characteristics.What is New:• There is a gap in the literature on the use of TA for securing vascular access devices in neonates, particularly regarding its safety and effectiveness in preventing failures and complications.• Further studies are needed to provide robust evidence verifying the effectiveness and safety of TA in this population.

show abstract

Functional Duration of Peripheral Intravenous Cannula in Neonates with or without Splint: A Randomized Controlled Trial

et al. 2023

View full text Add to dashboard Cite

Evaluation of unmodifiable and potentially modifiable factors affecting peripheral intravenous device-related complications in neonates: a retrospective observational study

Cited by 20 publications

References 32 publications

The ABBA project (Assess Better Before Access): a retrospective, cross-sectional study of neonatal intravascular device outcomes

The ABBA project (Assess Better Before Access): a retrospective, cross-sectional study of neonatal intravascular device outcomes

Use of tissue adhesive for neonatal intravenous access devices: A scoping review

Functional Duration of Peripheral Intravenous Cannula in Neonates with or without Splint: A Randomized Controlled Trial

Contact Info

Product

Resources

About