Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs

Abstract

To report the incidence and type of peripheral intravenous catheter complications in hospitalised dogs.MethOds: A prospective, observational trial was performed. Peripheral intravenous catheters were monitored for complications. Complications were documented and classified as extravasation, phlebitis, dislodgement, occlusion and line breakage. If phlebitis was present, the Visual Infusion Phlebitis Scale was used to assign a grade (0 to 5). Fisher's exact test was used to compare the type of complications between the critical care unit and the intermediate care unit. A univariate logistic model was used to compare the incidence of complications between the critical care unit and the intermediate care unit and adjusted odds ratios were used to compare the groups.Results: The incidence of peripheral intravenous catheter complications was 24.2% in the Critical Care Unit and 13.1% in the Intermediate Care Unit, with an overall incidence of 19.9%. Phlebitis was the most common peripheral intravenous catheter complication in the Critical Care Unit, and line breakage was the most common complication in the Intermediate Care Unit. Length of hospitalisation and weight had a significant effect on the likelihood of complication. In a multivariable logistic regression model, the odds of a peripheral intravenous catheter complication was not significantly higher in CCU than IMCU, accounting for length of hospitalisation and weight (adjusted odds ratio, 1.84; 95% confidence interval, 0.98 to 3.48).clinical significance: Peripheral intravenous catheter complications are common in hospitalised dogs and may result in an increased expense for owners, failure to deliver prescribed treatments, venous depletion (lack of peripheral vessels for intravenous catheter placement) and pain experienced by the patient. Techniques to reduce peripheral intravenous catheter complications should be further evaluated and may include the use of peripheral intravenous catheter placement and maintenance checklists, use of force-activated separation devices, or patient sedation.

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

“…The data collected related to PIVC monitoring included assessing the integrity of the catheter wrap; identification of swelling of the limb above or below the insertion site; pain associated with flushing the PIVC; checking for signs of inflammation such as palpable heat, swelling, pain, or redness; and observing the presence of blood at the insertion site. 3,19 Peripheral intravenous catheter complications were classified as extravasation, phlebitis, dislodgement, occlusion, line breakage, or patient removal as previously defined. 3 When a PIVC complication occurred, data were recorded on a PIVC complicationsspecific DCF and included patient demeanor, classification of the complication, and PIVC dwell time.…”

“…3,19 Peripheral intravenous catheter complications were classified as extravasation, phlebitis, dislodgement, occlusion, line breakage, or patient removal as previously defined. 3 When a PIVC complication occurred, data were recorded on a PIVC complicationsspecific DCF and included patient demeanor, classification of the complication, and PIVC dwell time. If a PIVC complication occurred outside of the twicedaily monitoring times, trained personnel completed the DCF.…”

“…In a different study, the combination of indwelling time and higher visual infusion phlebitis (VIP) scores were associated with an increased risk of infectious PIVC complications in 70 hospitalized dogs. 2,3 In a population of 40 hospitalized cats, higher VIP scores were correlated with lack of sedation and male sex. 2 Recognizing risk factors for PIVC complications in veterinary patients is crucial for identifying at-risk individuals and for finding ways to reduce overall complication 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…”

“…Interestingly, comparison of PIVC complication rates in dogs hospitalized in the critical care unit at our institution showed an 8% to 14% reduction in complications after implementation of a new PIVC placement protocol in line with human guidelines (ie, including a semipermeable transparent dressing). 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.…”