Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study

Abstract

Background Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia. Methods and setting An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed. Results The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63–6.27), admission unit (AHR = 1.88, 95%CI: 1.07–4.02), sickness (AHR = 0.24, 95% CI: 1.31–4.66), medication type (AHR = 2.04, 95%CI: 1.13–3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02–0.99), clinical experience (AHR = 0.52, CI:0.26–0.84), and flushing (AHR = 0.71, 95%CI: 0.34–0.98) were potential predictors of PIVC complication. Conclusion Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.

Nomogram for Predicting the Risk of Complications in Hospitalized Children With Peripheral Intravenous Catheters

“…The noninfectious complications of PIVC were high in this study, and the most common incidence was infiltration (42.5%), similar to the conclusion drawn from a meta-analysis of pediatric PIVC complications 2 . In this study, the infant is the most vulnerable children group and requires more attention during PIVC treatment 5,22 . As previously reported, being physically active and having less awareness may explain noninfectious PIVC complications 11 .…”

“…2 In this study, the infant is the most vulnerable children group and requires more attention during PIVC treatment. 5,22 As previously reported, being physically active and having less awareness may explain noninfectious PIVC complications. 11 Our results show that the incidence of PIVC varies across wards, thus requiring individualized, standardized intravenous management with regular training to prevent noninfectious complications of PIVC in younger patients.…”

“…Based on a literature review and practice standards for infusion therapy, [2][3][4][5][6][7][8][9][10][11][12][13]15,19 the researchers designed an assessment tool to collect risk factors for PIVC complications. The risk factors include patient demographics (4 items including age, sex, medical diagnosis, and place of admission), catheter insertion characteristics (8 items including catheter inserted vascular condition, site of insertion, type of the catheter, size of the catheter, type of needless connectors, tension-free bonding, limb immobilization, and needle adjustment), and catheter maintenance characteristics (9 items including antibiotics therapy, blood transfusion, infusion method, pressing on the site, evaluation, change dressing, infusion frequency, infusion speed, and infusion length).…”

“…The prevalence rate of PIVC complications is high in the pediatric population, ranging from 34.0% to 56.0% 2 . Among the complications, infiltration, extravasation, phlebitis, obstruction, and accidental removal are the main complications in hospitalized children, 3 leading to premature removal and replacement of PIVC but also increased pain and fear when reindwelling PIVC needles 4,5 . In addition, multiple punctures increase the risk that the child will not have a suitable site for PIVC placement, namely, venous failure and difficult intravenous access, 6 which is typically defined as 2 or more failed insertion attempts 7 .…”

“…2 Among the complications, infiltration, extravasation, phlebitis, obstruction, and accidental removal are the main complications in hospitalized children, 3 leading to premature removal and replacement of PIVC but also increased pain and fear when reindwelling PIVC needles. 4,5 In addition, multiple punctures increase the risk that the child will not have a suitable site for PIVC placement, namely, venous failure and difficult intravenous access, 6 which is typically defined as 2 or more failed insertion attempts. 7 In severe cases, the PIVC complications can lead to local tissue infection, necrosis, or even loss of function, 8 increased medical costs, and prolonged hospital stay.…”