Fewer peripheral intravenous catheter complications in hospitalized dogs when force-activated separation devices are used versus not used in a randomized controlled clinical trial

Abstract

OBJECTIVE To determine whether the use of a force-activated separation device (FASD) lowers the incidence risk of peripheral intravenous catheter (PIVC) complications in hospitalized dogs. ANIMALS 367 dogs that were hospitalized and received IV fluids between January 11 and March 25, 2021. PROCEDURES A prospective, randomized controlled clinical trial was performed. Dogs hospitalized and receiving IV fluids for at least 24 hours were randomized to the FASD group or control group. PIVCs were placed following a standardized protocol. Dogs in the FASD group had the FASD device attached to their PIVC according to manufacturer instructions. For both groups, all PIVC complications were documented, and each complication was classified as extravasation, phlebitis, dislodgement, occlusion, or line breakage. RESULTS Results from 367 dogs (FASD group = 180, control group = 187) underwent analysis. The proportion of PIVC complications was significantly (P = .004) lower for the FASD group (8.9% [16/180]) versus the control group (24.6% [46/187]). Following adjustment for differences in hospitalization time, the odds of a dog in the FASD group having a PIVC complication was approximately one-third the odds of those in the control group (OR, 0.33; 95% CI, 0.17 to 0.63; P = .001). CLINICAL RELEVANCE Results indicated that the use of a FASD in hospitalized dogs receiving IV fluids is warranted to lower the incidence of PIVC complications and may also limit patient discomfort, owner expense, and staff time devoted to managing PIVC complications. Further research investigating its use in cats and other species should be considered.

Smaller-gauge catheters and greater body weights are associated with increased risk of peripheral intravenous catheter complications in cats hospitalized in the critical care unit

“…[21][22][23] Identifying the specific factors associated with dislodgement was beyond the scope of our study; however, twice-daily assessments may have led to loosening of the dressing, and patient mobility or positioning might have contributed to our overall dislodgement rate. Force-activated separation devices, although not used in our study, have shown promise in reducing PIVC complications in dogs, 9 suggesting potential for future investigation in cats. Overall, our study suggested that maintaining clean, dry, and intact PIVC dressings, along with secure catheter placement, may aid in reducing dislodgement rates.…”

“…In veterinary medicine, PIVC-related complications have been described as extravasation, phlebitis, dislodgment, occlusion, line breakage, and patient removal. [3][4][5][6][7][8][9] Noninfectious PIVC complication rates…”

“…3,10 Other considerations to reduce PIVC complication rates in dogs include the utilization of a force-activated separation device wherein the PIVC complication rate was shown to be significantly reduced to 8.9% compared to 24.2% in the control group. 9 While guidelines do not exist in veterinary medicine, the available literature seems to support the benefit of insertion site protection with a transparent, semipermeable dressing as well as force-activated separation devices to reduce PIVC complication rates in hospitalized dogs, which might apply to cats as well.…”