Anaphylaxis and anaphylactoid reactions associated with the insertion of peripherally inserted central catheters: A multiyear comparative retrospective cohort study

Perioperative anaphylaxis associated with peripheral inserted central catheter: A retrospective observational study

BACKGROUND

Peripheral Inserted Central Catheter (PICC) is a commonly utilized medical device for long-term intravenous therapy in healthcare settings. However, there has been a notable increase in anaphylaxis associated with PICC catheterization, which should not be neglected.

AIMS

The purpose is to raise awareness about the occurrence of anaphylaxis or anaphylactoid reactions associated with PICC and to emphasize the need to explore effective methods to prevent this emergency event in the future.

METHOD

This retrospective observational study was conducted at Sun Yat-sen University Cancer Center between January 2021 and August 2023.

RESULTS

0.10% (13 out of 12,612) of cancer patients suffered from anaphylactic reactions during PICC catheterization. The duration time of anaphylaxis or anaphylactoid reactions was approximately 8 min, with a range of 5-10 min. The signs and symptoms combined with respiratory and cardiovascular system symptoms. Most patients were relieved spontaneously by oxygen inhalation and completed catheterization after their symptoms were alleviated.

CONCLUSION

The increasing incidence of anaphylaxis related to PICC catheterization necessitates greater awareness among healthcare providers. Further research is needed to identify the exact culprits during PICC insertion and develop effective strategies for preventing anaphylactic reactions.

A prospective observation of PICC related anaphylactoid reactions

PURPOSE

To explore the incidence, signs and symptoms, causes and prognosis of anaphylactoid reactions in PICC catheterization.

METHODS

Prospectively observe the occurrence of anaphylactoid reactions in coated and uncoated PICC during insertion from November 2018 to April 2020. A diagnosis of anaphylactoid reactions was based on the signs and symptoms and laboratory results, and then collect data for analysis.

RESULTS

A total of 1439 coated catheters were inserted, of which 30 resulted in anaphylactoid reactions (2.08%). The signs and symptoms were mainly skin system symptoms, combined with respiratory, cardiovascular, and digestive system symptoms. The anaphylactoid reaction rates of coated catheters were higher than those of uncoated catheters (χ2 = 38.417, 19.352, p < .01). A 29 of 30 patients completed catheterization after symptoms were resolved, these catheters were removed after treatment completion. Catheterization was terminated in one patient. There were no anaphylactoid reactions in 2850 uncoated catheters.

CONCLUSION

Anaphylactoid reactions may occur during catheterization when using the coated PICC, which should be paid attention to in clinical application.

Re-evaluating expanding intravenous catheters in medical practice

BACKGROUND

Intravenous catheters are common and essential devices within medical practice. Their placement can be difficult, leading to application of several technologies to improve success. Functionally expanding catheters were once an exciting technology, derailed clinically by hypersensitivity reactions. The exact cause of reactions, attributed to Aquavene catheter materials, remains unknown.

AIMS

To reinvestigate functionally expanding intravenous catheters.

MATERIALS AND METHODS

The history of the functionally expanding intravenous catheter is presented here along with its utility in current medical practice, potential for further investigation, and possible redesign of these once promising devices.

RESULTS

This review demonstrates clinical utility and a lack of definitive cause for failure of the previous functionally expanding intravenous catheter design. As Aquavene materials themselves are commonly considered the cause of hypersensitivity reactions which removed expanding intravenous catheters from the market, this review found several possible substitutes for this material for use in any redesign.

DISCUSSION AND CONCLUSION

The functionally expanding intravenous catheter failed due to hypersensitivity reactions in patients. Alternative materials exist for a possible redesign on this once promising clinical product.