Peripheral intravenous catheter non‐infectious complications in adults: A systematic review and meta‐analysis

Abstract

Aims The aim of this systematic review and meta‐analysis was to summarize and quantify peripheral intravenous catheter‐related complications. Design This systematic review is reported by means of the Cochrane process for randomized controlled trials and the Meta‐analysis of Observation Studies in Epidemiology for cohort studies. Data sources The Cochrane Central Register of Controlled Trials, PubMed, CINAHL and EMBASE databases, clinical trial registries such as ClinicalTrials.gov and the reference list of included studies were searched from 2000 ‐April 2019. Review Methods Using a purpose designed data extraction tool, two authors independently identified studies for full review, data extraction and quality assessment. Dichotomous outcomes were pooled after Freeman–Tukey double arcsine transformation using random‐effects meta‐analysis; estimates of heterogeneity were taken from inverse‐variance fixed‐effect models. Results Seventy observational studies and 33 randomized controlled trials were included (76,977 catheters). Peripheral intravenous catheter‐related complications were as follows: phlebitis (with definition) 19.3%, phlebitis (without definition) 4.5%, infiltration/extravasation 13.7%, occlusion 8%, leakage 7.3%, pain 6.4% and dislodgement 6.0%. Subgroup analysis found infiltration/extravasation for emergency department‐inserted catheters was significantly higher (25.2%; p = .022) than for those inserted in other departments and pain was significantly higher (p < .001) in countries with developing economies compared with developed economies. Conclusion Peripheral intravenous catheter complications are unacceptably common worldwide. This review suggests substantial and multi‐specialty efforts are needed to address the sequalae associated with complications. The potential benefits for patients and health services are considerable if complications are reduced. Impact Peripheral intravenous complications interrupt important treatment which can be distressing for patients and result in longer hospital stays with increased healthcare costs. This review found phlebitis and infiltration are the most prevalent reason for catheter failure. These results provide nurses with a strong evidence base for the development of effective interventions for practice which are vital for preventing poor outcomes for patients with peripheral intravenous catheters.

Nurses’ Practices in the Peripheral Intravenous Catheterization of Adult Oncology Patients: A Mix-Method Study

“…In this study, during phase one, a high complication rate (26%) was identified mainly due to infiltration and phlebitis, which are the two most reported complications internationally [52]. This finding is lower than most studies conducted in Portugal, with complications rates varying between 50% and 62.1% [33,34,39,53], although none of the studies was conducted in an oncology setting.…”

Multimodal intervention for preventing peripheral intravenous catheter failure in adults (PREBACP): a multicentre, cluster-randomised, controlled trial

“…PIVC failure is a frequent complication of PIVC use, with ~40 -70% of these catheters removed prematurely due to mechanical and chemical complications (i.e. phlebitis, dislodgement, occlusion, infiltration) or infection before the completion of scheduled intravenous therapy [3][4][5] .…”

Time to Occurrence of Phlebitis After Continuous Infusion of Total Nutrient Admixture Through Peripheral Veins: An Experimental Animal Study

“…Currently, short peripheral venous catheters (PVCs) are commonly used for intravenous infusion in hospitals, with a utilization rate as high as 70%. 1 However, for such an important device PVCs remain highly susceptible to complications resulting in catheter failure, which has been reported in individual studies to be as high as 69%, but worldwide literature has never been systematically synthesized which may lead to an underappreciation of these rates. 2 Phlebitis has the highest incidence, accounting for 24% of all complications, 1 and the physical and chemical properties of the drugs being used is one of the main risk factors for phlebitis.…”

“…1 However, for such an important device PVCs remain highly susceptible to complications resulting in catheter failure, which has been reported in individual studies to be as high as 69%, but worldwide literature has never been systematically synthesized which may lead to an underappreciation of these rates. 2 Phlebitis has the highest incidence, accounting for 24% of all complications, 1 and the physical and chemical properties of the drugs being used is one of the main risk factors for phlebitis. Yanhong Wang studied the limit time of chemical phlebitis caused by strong acid drug amiodarone.…”