Younger age and <i>in situ</i> duration of peripheral intravenous catheters were risk factors for extravasation in a retrospective paediatric study

Fonzo-Christe, Caroline; Parron, A; Combescure, Christophe; Rimensberger, Peter C.; Pfister, Riccardo; Bonnabry, Pascal

doi:10.1111/apa.14280

Cited by 17 publications

(17 citation statements)

References 21 publications

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“…Extravasation injury (EI) resulting from intravenous (IV) therapies delivered via peripheral intravenous catheters or umbilical and peripherally inserted central venous catheters (CVCs) is a common iatrogenic complication occurring in neonatal intensive care units (NICUs) [ 1 , 2 ]. The incidence and prevalence of peripheral intravenous extravasation among neonates is approximately 12.6 per 100 peripheral intravenous catheter days and 38 per 1,000 neonates, respectively [ 3 , 4 ]. Serious life-threatening cases of peripheral intravenous extravasation and extravasation from a central line have been reported in 92% of the surveyed NICUs in Australia and New Zealand [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have reported that neonates born before 37 weeks of pregnancy; having low birth weight, active limb movements, and longer in-situ peripheral intravenous catheter duration; and receiving parenteral nutrition are prone to developing EI [ 1 , 3 , 6 – 8 ]. The type of peripheral intravenous catheters used and the insertion of disproportionately large peripheral intravenous catheters are also associated with neonatal extravasation [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

et al. 2020

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Background Extravasation injury resulting from intravenous therapies delivered via peripheral intravenous catheters or umbilical and peripherally inserted central venous catheters is a common iatrogenic complication occurring in neonatal intensive care units. This study aimed to evaluate the effectiveness of an evidence-based clinical practice guideline in the prevention and management of neonatal extravasation injury by nurses. Methods A controlled before-and-after study was conducted in a neonatal unit. The clinical practice guideline was developed, and a multifaceted educational program was delivered to nurses. Neonatal outcomes, including the rates of peripheral intravenous extravasation and extravasation from a central line, were collected at the pre- and post-intervention periods. Post-intervention data for nurses, including the nurses’ level of knowledge and adherence, were collected at six months after the program. Results 104 and 109 neonates were recruited in the pre-intervention period (control) and the post-intervention period (intervention), respectively. The extravasation rate before and after the intervention was 14.04 and 2.90 per 1,000 peripheral intravenous catheters days, respectively. The adjusted odds ratio of peripheral intravenous extravasation post-intervention compared with that of pre-intervention was 0.20 (95% confidence interval: 0.05–0.74; p = 0.02) after adjusting for peripheral intravenous catheter days. The extravasation from a central line rate of the control and intervention groups post-intervention was 4.94 and zero per 1,000 central venous catheter days, respectively. Fifty-nine registered nurses were recruited. At six months post-program, there were significant improvements in the nurses’ level of knowledge and adherence. Conclusions These findings suggest that the implementation of an evidence-based clinical practice guideline significantly reduced the rate of peripheral intravenous extravasation and extravasation from a central line in neonates. However, to maintain nurses’ knowledge and adherence to the evidence-based practice, the educational program will have to be conducted periodically and incorporated into the nurses’ induction program. Trial registration ClinicalTrials.gov, Identifiers: NCT04321447. Registered 20 March 2020 - Retrospectively registered.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

et al. 2020

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“…However, the American INS (15) suggests that veins in the antecubital fossa are avoided as sites for PIC because they limit the child's movements. According to some studies, the insertion of catheters into the veins of the antecubital fossa (24) and the dorsum of the hand (5) generates a higher occurrence of complications, such as infiltration (1,24) , extravasation (25) and phlebitis (26)(27) .…”

Section: Care Related To Peripheral Intravenous Catheterism In Pediatrics Performed By Nursing Techniciansmentioning

confidence: 99%

Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians

et al. 2022

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Objectives: to evaluate the care practice adopted by nursing technicians before, during and after peripheral intravenous catheterization performed in hospitalized children. Methods: cross-sectional and descriptive research, carried out in a pediatric hospital in Bahia through non-participatory observation of peripheral intravenous catheterizations performed in children by nursing technicians. Data was collected through an instrument containing care related to the moments before, during and after insertion of the catheter, calculating absolute and relative frequencies, measures of central tendency and dispersion. Results: there were 31 nursing technicians, who performed care mainly before intravenous catheterization. Nonconformities were identified regarding hand hygiene, use of a disposable mask, selection of the catheter insertion site, antisepsis, stabilization and catheter coverage. Conclusions: most of the precautions observed regarding peripheral intravenous catheterization are not in accordance with the standards of practice recommended by the national and international literature.

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“…44 Furthermore, younger age is also a risk factor for catheter failure. [46][47][48] Five studies documented LPC use in children, with all authors highlighting the advantages of LPCs over PIVCs. There is potential that LPCs may reduce the number of PIVCs required during an admission and subsequently reduce the instances of needle trauma.…”

Section: Outcomementioning

confidence: 99%

Long peripheral catheters for intravenous access in adults and children: A systematic review of the literature

et al. 2020

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Background: Long peripheral catheters are peripheral intravenous catheters of 6–15 cm in length. They are commonly inserted into the forearm, antecubital fossa or upper arm using a direct Seldinger technique. They have proven to be valuable for peripheral intravenous catheters, particularly in patients with difficult intravenous access. Methods: We conducted a systematic review of studies reporting the use of long peripheral catheters. The following keywords were used: ‘long’, ‘Seldinger’, ‘guidewire’, ‘peripheral’, ‘venous’, ‘intravenous’, ‘IV’, ‘vascular’, ‘cannula’ and ‘catheter’. Results: Three hundred forty-one publications were identified; 16 were included in the systematic review. There were 11 adult studies and 5 paediatric studies documenting 1288 long peripheral catheters in 1271 patients. Majority of studies (12/16) were conducted in acute care settings, (emergency department, n = 6; intensive care unit, n = 3; high dependency unit, n = 1; surgical unit, n = 2). The most frequently studied long peripheral catheter was 8 cm in length and 20 G in size. Nine studies recruited patients with difficult intravenous access; 11 studies used ultrasound guidance. Insertion success rate and mean procedural time ranged between 86% and 100% and 8 and 16.8 minutes, respectively. Average catheter duration ranged between 4 and 14.7 days (mean) and 1.1 and 9 days (median). Catheter failure occurred in 4.3–52.5% of long peripheral catheters, with leakage, infiltration and dislodgement being the most frequent causes of failure. In 3 randomised controlled trials, long peripheral catheters outperformed peripheral intravenous catheters in terms of duration and failure rate. Conclusion: Long peripheral catheters are safe and reliable in both adults and children. In addition, long peripheral catheters may provide improved quality of care over peripheral intravenous catheters for multi-day intravenous therapy.

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Younger age and in situ duration of peripheral intravenous catheters were risk factors for extravasation in a retrospective paediatric study

Abstract: Extravasation was frequent and neonates were particularly at risk. Younger age and longer in situ PIVC duration were independent risk factors for extravasation.

Cited by 17 publications

References 21 publications

Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians

Long peripheral catheters for intravenous access in adults and children: A systematic review of the literature

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