Factors affecting the patency and complications of peripheral intravenous catheters in newborns

Ju-Huei Tseng, Ying-Fang Elaine Chen, Sun-Peng Chang, Hsiao-Chin Wang, Yung-Ting Kuo

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摘要

Background Peripheral intravenous catheters (PICs) are necessary for medication, nutrient, and fluid administration in pediatric patients. However, PICs are uneasy to access and maintain in young infants. This study identified risk factors affecting the complications and patency of PICs. Methods This retrospective cohort study included neonates and infants aged < 4 months. All PICs inserted in the neonatal intensive care unit and intermediate care nursery were analyzed over 5 months. The variables included gestational age, age and body weight at PIC insertion, insertion site, methods to maintain PIC patency (continuous intravenous drip [CIVD] versus intermittent flushing), fluid infusion rate and osmolarity, and ampicillin and cefotaxime concentrations. The effects of these variables on PIC complications and lifespan were assessed using binary logistic regression analysis and a general linear model, respectively. Results In total, 315 PICs were analyzed. The mean indwelling time was 33.8 ± 21.5 h and complication rate was 82.2%. The most frequent complications were infiltration (55.9%) and leakage (22.2%). The infusion rate and method to maintain PICs significantly impacted PIC patency. A negative correlation was noted between the infusion rate and PIC patency, with the patency decreasing by 0.9 h (p = 0.047) on increasing the infusion rate by 1 mL/h. Notably, compared with intermittent flushing, CIVD using a hypertonic solution significantly decreased PIC patency by 14 h (p = 0.006). As the patients’ age increased by a month, the complication risk decreased by 35% (p = 0.027). However, as the infusion rate increased by 1 mL/h, the complication risk increased by 17% (p = 0.018). Conclusions Intermittent flushing may be preferred over CIVD to preserve PIC patency. An increased infusion rate is correlated with decreased PIC patency and increased complications. For the peripheral administration of ampicillin, we recommended preparing final concentrations below 50 mg/dL to prevent PIC complications.
原文中文
期刊Acta Paediatrica Sinica
DOIs
出版狀態已發佈 - 2022

Keywords

  • cannula patency
  • intensive care
  • intermittent flushing
  • newborn
  • peripheral intravenous catheter

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