Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates

Abstract

Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates * Extracted from the dissertation "Complicações relacionadas ao uso do cateter intravenoso periférico em neonatos", Universidade Federal do Paraná, 2013. ABSTRACT Objective:To evaluate the incidence of complications related to the use of peripheral intravenous catheter in neonates and identify the associated risk factors. Method: Prospective cohort study conducted in a Neonatal Intensive Care Unit. Participants were the hospitalized neonates undergoing peripheral intravenous puncture in the period from February to June 2013. Results: The incidence of complications was 63.15%, being infiltration/extravasation (69.89%), phlebitis (17.84%) and obstruction (12.27%). The risk factors were the presence of infection (p = 0.0192) and weight at the puncture day (p = 0.0093), type of intermittent infusion associated with continuous infusion (p <0.0001), endotracheal intubation (p = 0.0008), infusion of basic plan (p = 0.0027), total parenteral nutrition (P = 0.0002), blood transfusion associated with other infusions (p = 0.0003) and other drugs (p = 0.0004). Higher risk of developing complications in the first 48 hours after puncture. Conclusion: A high rate of complications related to the use of peripheral intravenous catheter, and risk factors associated with infection, weight, drugs and infused solutions, and type of infusion. DESCRIPTORS

Utilização do cateter central de inserção periférica em neonatos: análise da indicação à remoção

“…As características anatômicas, fisiológicas e cognitivas inerentes à faixa etária do neonato podem influenciar no sucesso da punção, bem como prematuridade, existência de doença crônica, tratamento cirúrgico prolongado, terapia intravenosa periférica prolongada e uso de medicamentos vesicantes (15) , sendo, portanto, necessário o enfermeiro ter conhecimento acerca da anatomia, fisiologia da pele e do sistema venoso e capacidade de avaliar condições clínicas e ou cirúrgicas específicas de cada neonato.…”

“…Durante a inserção do cateter, podem ocorrer intercorrências, como dificuldade de progressão do cateter, sangramento, hematomas, risco para formação de trombose e flebite (15) . Neste estudo, as principais intercorrências foram dificuldade de acesso, progressão do cateter e sangramento.…”

“…Quanto aos motivos de remoção do cateter central de inserção periférica, confirma-se a prevalência de remoção eletiva, por término da terapia intravenosa e ou alta da unidade de terapia intensiva (12) , além de extração por complicações, como infiltração, extravasamento, tromboflebite, infecção local (15) , entre outros. Estes últimos, pouco evidentes na unidade de terapia intensiva neonatal estudada.…”

Parenteral nutrition therapy for neonates: Experience in a tertiary care centre in Sri Lanka

“…Due to the increased rate of complications associated with umbilical catheter use in PN administration, many neonatal units prefer to use percutaneous intravenous catheters (PIC) for PN 14 . Though placing PIC is potentially difficult, it has a better delivery of nutrition and is more stable than peripheral cannula and is less associated with invasive infections than peripheral cannula 15,16 . However, the nutritional impact of various routes on neonatal growth and long term outcome is not clear and there is limited data available.…”

Assessment of nurses’ knowledge and practice regarding the use of transillumination device for establishing venous access

“…Venous prominence is further augmented using tourniquet. Gently wiping the skin with an alcohol swab may help visualization of the vein as the reflection of the light off the skin changes [5], [8]. An average of 2 attempts is necessary to insert a peripheral IV catheter in a critical newborn.…”