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Liu C, Chen L, Kong D, Lyu F, Luan L, Yang L. Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients. J Vasc Access 2020; 23:57-66. [PMID: 33302797 DOI: 10.1177/1129729820978124] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Peripheral intravenous catheters (PVCs) are widely used vascular access devices for infusion therapy; however, they are associated with relatively high failure rates. This study aimed to identify the incidence, risk factors and medical costs of PVC-induced complications in adult hospitalised adult patients in China. METHODS An observational, prospective study on 1069 patients lasting 5 months was conducted at a tertiary teaching hospital. RESULTS Infiltration ranked first among PVC complications with an incidence of 17.8%, followed by occlusion (10.8%) and phlebitis (10.5%). Most complications in phlebitis (88.4%) and infiltration (93.7%) were Grade 1. Catheters left in for over 96 h did not show a higher incidence of complications. Patients from the surgical department were more susceptible to infiltration, phlebitis and occlusion. The 26 gauge (Ga) catheters decreased the risk of phlebitis and occlusion, whereas 24Ga catheters increased infiltration rates. Infusing irritant drugs increased phlebitis and infiltration rates. The presence of comorbidities and non-use of needleless connectors were associated with occlusion. Compared with forearm insertion, the risk of occlusion nearly doubled with the dorsum of the hand insertion and the risk of infiltration tripled with antecubital fossa insertion. Medical treatment costs for PVC complications ranged from 0.3 to 140.0 CNY. CONCLUSIONS Infiltration is the most common PVC-related adverse event. Clinically-indicated instead of routine replacement of catheters is safe. More efforts are warranted to improve nurses' adherence to recent guidelines in terms of insertion site selection and needleless connector utilisation to reduce medical costs associated with catheter replacement.
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Affiliation(s)
- Congcong Liu
- Ward III, Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Lin Chen
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Dong Kong
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Fangfang Lyu
- Department of Cardiac Surgical Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Linlin Luan
- Ward II, Department of Anesthesia Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Lijuan Yang
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
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Bush K, Odunayo A, Hedges K, Guieu LV, Smith R, Okafor C. Peripheral Intravenous Catheter Complications in Hospitalized Cats: An Observational Pilot Study. Top Companion Anim Med 2020; 41:100456. [PMID: 32823155 DOI: 10.1016/j.tcam.2020.100456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES There is little information about complications associated with peripheral catheter use in cats. The primary objective of this study was to determine the main reason for catheter removal in cats hospitalized in the Intensive Care Unit at a university teaching hospital. The secondary objective was to describe catheter-associated complications in cats hospitalized. METHODS All feline patients with peripheral intravenous catheters admitted to the Intensive Care Unit between June and August 2017 were prospectively enrolled in this study. All catheters were evaluated at least 3 times a day per institutional Intensive Care Unit protocol. The catheters were monitored throughout the cat's hospitalization period for development of complications, including occlusion, phlebitis and extravasation. Data collected included patient signalment, reason for hospitalization, catheter size and location, number of hours the catheter remained in place, reason for removal and if the catheter was replaced once removed. RESULTS Thirty-four cats were enrolled in the study, and a total of 42 catheters were placed in those cats. Median peripheral IV catheter duration was 23.8 hours (interquartile range [IQR] 13.8-41.3 hours). The most frequent reason for catheter removal was patient discharge from the hospital (24/42, 57.1%). Overall catheter complication rate was 21.4% (9/42). Complications observed included phlebitis, extravasation, patient removal, occlusion, and edema formation. CLINICAL SIGNIFICANCE The results of this study conclude that the majority of peripheral IV catheters in cats are removed due to discharge from hospitalization. More studies with a larger population of cats are needed to see if there is a relationship between length of indwelling catheterization and risk of catheter-associated complications.
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Affiliation(s)
- Kaleigh Bush
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA.
| | - Katherine Hedges
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
| | - Liz-Valérie Guieu
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
| | - Rebecca Smith
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
| | - Chika Okafor
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
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Takezawa Y, Izumi K, Kamijima T, Machioka K, Shima T, Iwamoto H, Nohara T, Shigehara K, Kadono Y, Seto C, Mizokami A. Effectiveness of Synthetic Polymer-coated Peripherally Inserted Central Catheter in Patients With Advanced Cancer. In Vivo 2019; 33:877-880. [PMID: 31028211 DOI: 10.21873/invivo.11553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM A peripherally inserted central catheter (PICC) is recommended for the safe administration of anticancer agents. The effectiveness of synthetic polymer-coated and non-coated PICCs was compared. PATIENTS AND METHODS Patients with advanced cancers who had indwelling PICCs were reviewed using their medical records. Three types of PICCs were compared in terms of complications and catheter failure. RESULTS A total of 90 patients were retrospectively analyzed, including 31 with Groshong PICCs, 30 with Argyle PICC kit, and 29 with Argyle PICC kit II. The incidence of catheter failure for Groshong PICC, Argyle PICC kit, and Argyle PICC kit II per 1,000 PICC days was 4.4614, 5.6617, and 0.8658, respectively. Catheter failure-free survival in the Argyle PICC kit II group was significantly better than that in the Argyle PICC kit group (p=0.0339). CONCLUSION Argyle PICC kit II, a synthetic polymer-coated PICC, may render longer patency and prevention of catheter failure than non-coated PICCs.
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Affiliation(s)
- Yuta Takezawa
- Department of Urology, Toyama Prefectural Central Hospital, Toyama, Japan.,Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Taiki Kamijima
- Department of Urology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Kazuaki Machioka
- Department of Urology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Takashi Shima
- Department of Urology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hiroaki Iwamoto
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Takahiro Nohara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Chikashi Seto
- Department of Urology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
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Castillo MI, Larsen E, Cooke M, Marsh NM, Wallis MC, Finucane J, Brown P, Mihala G, Carr PJ, Byrnes J, Walker R, Cable P, Zhang L, Sear C, Jackson G, Rowsome A, Ryan A, Humphries JC, Sivyer S, Flanigan K, Rickard CM. Integrated versus nOn-integrated Peripheral inTravenous catheter. Which Is the most effective systeM for peripheral intravenoUs catheter Management? (The OPTIMUM study): a randomised controlled trial protocol. BMJ Open 2018; 8:e019916. [PMID: 29764876 PMCID: PMC5961612 DOI: 10.1136/bmjopen-2017-019916] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Peripheral intravenous catheters (PIVCs) are frequently used in hospitals. However, PIVC complications are common, with failures leading to treatment delays, additional procedures, patient pain and discomfort, increased clinician workload and substantially increased healthcare costs. Recent evidence suggests integrated PIVC systems may be more effective than traditional non-integrated PIVC systems in reducing phlebitis, infiltration and costs and increasing functional dwell time. The study aim is to determine the efficacy, cost-utility and acceptability to patients and professionals of an integrated PIVC system compared with a non-integrated PIVC system. METHODS AND ANALYSIS Two-arm, multicentre, randomised controlled superiority trial of integrated versus non-integrated PIVC systems to compare effectiveness on clinical and economic outcomes. Recruitment of 1560 patients over 2 years, with randomisation by a centralised service ensuring allocation concealment. Primary outcomes: catheter failure (composite endpoint) for reasons of: occlusion, infiltration/extravasation, phlebitis/thrombophlebitis, dislodgement, localised or catheter-associated bloodstream infections. SECONDARY OUTCOMES first time insertion success, types of PIVC failure, device colonisation, insertion pain, functional dwell time, adverse events, mortality, cost-utility and consumer acceptability. One PIVC per patient will be included, with intention-to-treat analysis. Baseline group comparisons will be made for potentially clinically important confounders. The proportional hazards assumption will be checked, and Cox regression will test the effect of group, patient, device and clinical variables on failure. An as-treated analysis will assess the effect of protocol violations. Kaplan-Meier survival curves with log-rank tests will compare failure by group over time. Secondary endpoints will be compared between groups using parametric/non-parametric techniques. ETHICS AND DISSEMINATION Ethical approval from the Royal Brisbane and Women's Hospital Human Research Ethics Committee (HREC/16/QRBW/527), Griffith University Human Research Ethics Committee (Ref No. 2017/002) and the South Metropolitan Health Services Human Research Ethics Committee (Ref No. 2016-239). Results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12617000089336.
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Affiliation(s)
- Maria Isabel Castillo
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Emily Larsen
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Marie Cooke
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Nicole M Marsh
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Marianne C Wallis
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Julie Finucane
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Peter Brown
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Gabor Mihala
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Peter J Carr
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Rachel Walker
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Prudence Cable
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Li Zhang
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Candi Sear
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Gavin Jackson
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Anna Rowsome
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Alison Ryan
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Julie C Humphries
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Susan Sivyer
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Kathy Flanigan
- Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Claire M Rickard
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
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