Incidence, risk factors, and assessment of induration by ultrasonography after chemotherapy administration through a peripheral intravenous catheter

ABSTRACT Objectives: to analyze predictive factors for the incidence of complications related to peripheral venous catheters in children and adolescents with cancer. Methods: a longitudinal follow-up study, conducted at a pediatric oncology clinic unit of a hospital in Bahia, with 333 peripheral venous catheters inserted in 77 children and 26 adolescents. Data collection took place between April 2015 and December 2016 through direct observation of peripheral intravenous catheter insertion, medical record data collection and daily observation of the puncture site. Results: the incidence of complications was 18.6%. The modeling of the variables confirmed that the risk factors for complications in children/adolescents with cancer were: prolonged peripheral intravenous therapy (p=0.002), history of complications (p=0.000), non-irritating/vesicant medications (p=0.003) and vesicant solutions (p=0.000). Conclusions: the goal has been achieved. Results can contribute to the theoretical, practical and social context.

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The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis

The Journal of Vascular Access ◽

10.1177/1129729819877323 ◽

2019 ◽

Vol 21 (3) ◽

pp. 342-349 ◽

Cited By ~ 4

Author(s):

Luyu Lv ◽

Jiaqian Zhang

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Meta Analysis ◽

Female Gender ◽

Incidence Rates ◽

Intravenous Catheter ◽

Peripheral Intravenous Catheter ◽

Meta Analyses ◽

Intravenous Catheters

Introduction: Phlebitis is a common complication associated with the use of peripheral intravenous catheters. The aim of this study was to estimate the incidence of phlebitis with peripheral intravenous catheter use and to identify risk factors for phlebitis development. Method: Literature survey was conducted in electronic databases (CINAHL, Embase, Google Scholar, Ovid, and PubMed), and studies were included if they used peripheral intravenous catheter for therapeutic or volumetric infusion and reported phlebitis incidence rates. Random effects meta-analyses were performed to obtain overall and subgroup phlebitis incidence rates and odds ratio between males and females in phlebitis incidence. Results: Thirty-five studies were included (20,697 catheters used for 15,791 patients; age 57.1 years (95% confidence interval: 55.0, 59.2); 53.9% males (95% confidence interval: 42.3, 65.5)). Incidence of phlebitis was 30.7 per 100 catheters (95% confidence interval: 27.2, 34.2). Incidence of severe phlebitis was 3.6% (95% confidence interval: 2.7%, 4.6%). Incidence of phlebitis was higher in non-intervened (30% (95% confidence interval: 27%, 33%)) than in intervened (21% (95% confidence interval: 15%, 27%)) groups, and with Teflon (33% (95% confidence interval: 25%, 41%)) than Vialon (27% (95% confidence interval: 21%, 32%)) cannula use. Odds of developing phlebitis was significantly higher in females (odds ratio = 1.42 (95% confidence interval: 1.05, 1.93); p = 0.02). Longer dwelling time, antibiotics infusion, female gender, forearm insertion, infectious disease, and Teflon catheter are important risk factors for phlebitis development identified by the included studies. Conclusion: Incidence of phlebitis with the use of peripheral intravenous catheters during infusion is 31%. Severe phlebitis develops in 4% of all patients. Risk of phlebitis development can be reduced by adapting appropriate interventions.

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Cateter periférico com sistema fechado de infusão: implementação de tecnologia

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v13i5a239008p1208-1215-2019 ◽

2019 ◽

Vol 13 (5) ◽

pp. 1208

Author(s):

Jolline Lind ◽

Mitzy Tannia Reichembach Danski ◽

Luana Lenzi ◽

Edivane Pedrolo ◽

Alessandra Amaral Schwanke ◽

...

Keyword(s):

Risk Factors ◽

Female Gender ◽

Intravenous Catheter ◽

Chi Square ◽

Local Complications ◽

Factores De Riesgo ◽

Peripheral Intravenous Catheter ◽

Associated Risk Factors ◽

Evidence Based Nursing ◽

Infusion System

RESUMO Objetivo: estimar a incidência de complicações locais relacionadas ao uso do cateter intravenoso periférico com sistema fechado de infusão e identificar os fatores de risco associados. Método: trata-se de um estudo quantitativo, de coorte prospectivo, realizado com 90 adultos. Realizou-se a coleta mediante a observação diária do cateter. Utilizaram-se, nas análises estatísticas, os testes Qui-Quadrado, Exato de Fisher, Correção de Williams, Mann-Whitney e Risco Relativo. Apresentaram-se os resultados em forma de tabelas. Resultados: informa-se que a incidência de complicações locais foi de 55,6%, sendo 15 (16,7%) flebites, 12 (13,3%) trações, dez (11,1%) infiltrações, sete (7,8%) extravasamentos, cinco (5,6%) obstruções e uma (1,1%) infecção local. Têm-se como fatores de risco o sexo feminino (p=0,005), o tempo de internação (p=<0,001) e a infusão em bomba (p=0,014). Conclusão: acredita-se que a taxa de complicações locais foi alta e identificaram-se três fatores de risco relacionados ao uso do cateter intravenoso periférico com sistema fechado de infusão. Descritores: Cateterismo Periférico; Tecnologia Biomédica; Fatores de Risco; Enfermagem Baseada em Evidências; Adulto; Infusões Intravenosas. ABSTRACT Objective: to estimate the incidence of local complications related to the use of a peripheral intravenous catheter with a closed infusion system and to identify the associated risk factors. Method: this is a quantitative, prospective cohort study with 90 adults. The collection was performed by daily observation of the catheter. The Chi-Square, Fisher's exact, Williams's Correction, Mann-Whitney and Relative Risk tests were used in the statistical analyzes. Results were presented in the form of tables. Results: the incidence of local complications was 55.6%, with 15 (16.7%) phlebitis, 12 (13.3%) traction, ten (11.1%) infiltrations, seven (7, 8%) extravasations, five (5.6%) obstructions and one (1.1%) local infection. The risk factors were female gender (p = 0.005), hospitalization time (p = 0.001) and pump infusion (p = 0.014). Conclusion: it is believed that the rate of local complications was high and three risk factors related to the use of the peripheral intravenous catheter with closed infusion system were identified. Descriptors: Peripheral Catheterization; Biomedical Technology; Risk factors; Evidence-Based Nursing; Adult; Intravenous Infusions. RESUMEN Objetivo: estimar la incidencia de complicaciones locales relacionadas al uso del catéter intravenoso periférico con sistema cerrado de infusión e identificar los factores de riesgo asociados. Método: se trata de un estudio cuantitativo, de cohorte prospectivo, realizado con 90 adultos. Se realizó la recolección mediante la observación diaria del catéter. Se utilizaron, en los análisis estadísticos, las pruebas Chi-Cuadrado, Exacto de Fisher, Corrección de Williams, Mann-Whitney y Riesgo Relativo. Se presentaron los resultados en forma de tablas. Resultados: se informa que la incidencia de complicaciones locales fue 55,6%, de los cuales 15 (16.7%) flebitis, 12 (13,3%) tracciones, diez (11,1%) la infiltración, siete (7 8%) extravasaciones, cinco (5,6%) obstrucciones y una (1,1%) infección local. Se toman como factores de riesgo el sexo femenino (p = 0,005), el tiempo de internación (p = <0,001) y la infusión en bomba (p = 0,014). Conclusión: se cree que la tasa de complicaciones locales fue alta y se identificaron tres factores de riesgo relacionados al uso del catéter intravenoso periférico con sistema cerrado de infusión. Descritores: Cateterismo Periférico; Tecnología Biomédica; Factores de Riesgo; Enfermería Basada em la Evidencia; Adulto; Infusiones Intravenosas.

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Risk Factors for Phlebitis in Patients with Peripheral Intravenous Catheters

Global Journal of Health Science ◽

10.5539/gjhs.v12n1p41 ◽

2019 ◽

Vol 12 (1) ◽

pp. 41

Author(s):

Fengmei Tan ◽

Silin Zheng ◽

Hongyan Wu ◽

Lixia Nie ◽

Wenhua Li ◽

...

Keyword(s):

Risk Factors ◽

Dwell Time ◽

Insertion Site ◽

Outer Diameter ◽

Hypertonic Solution ◽

Intravenous Catheter ◽

Infusion Solution ◽

Peripheral Intravenous Catheter ◽

Insertion Sites ◽

Intravenous Catheters

Introduction: The study investigated the risk factors of phlebitis associated with infusion by peripheral intravenous catheter (PIVC). Methodology: Hospitalized adults (n = 506) were placed with PIVCs by trained nurses. Rates of phlebitis were noted according to PIVC gauge, insertion site, and dwell time; and type and volume of infusion solution. Results: The development of phlebitis appeared to be significantly associated with the size of the outer diameter of the PIVC. The rate of phlebitis among patients given a hypertonic infusion solution was significantly higher; and also associated with infusion volume. There was no difference in phlebitis development among insertion sites, and dwell times among these sites were comparable. Conclusion: The risk of phlebitis increased with the PIVC size and volume of infusion solution, and use of a hypertonic solution. The recognition of risk factors and standardized intervention may reduce the occurrence of phlebitis associated with PIVC use.

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The Incidence of Peripheral Intravenous Catheter Phlebitis and Risk Factors among Pediatric Patients

Journal of Pediatric Nursing ◽

10.1016/j.pedn.2019.11.006 ◽

2020 ◽

Vol 50 ◽

pp. 89-93 ◽

Cited By ~ 1

Author(s):

Mohammad Suliman ◽

Wafa Saleh ◽

Hind Al-shiekh ◽

Wafa Taan ◽

Mohammed AlBashtawy

Keyword(s):

Risk Factors ◽

Pediatric Patients ◽

Intravenous Catheter ◽

Peripheral Intravenous Catheter

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Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital

Kathmandu University Medical Journal ◽

10.3126/kumj.v6i4.1732 ◽

1970 ◽

Vol 6 (4) ◽

pp. 443-447 ◽

Cited By ~ 8

Author(s):

R Singh ◽

S Bhandary ◽

KD Pun

Keyword(s):

Risk Factors ◽

Drug Administration ◽

Adult Population ◽

Insertion Site ◽

Incidence Rates ◽

Significant Problem ◽

Infusion Therapy ◽

Intravenous Therapy ◽

Intravenous Catheter ◽

Peripheral Intravenous Catheter

Background: Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to define the possible factors associated to its development. Materials and methods: Prospective observational study was carried out on 230 clients who were under first time peripheral infusion therapy during two months period: September - October, 2007. Peripheral infusion site was examined for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis. SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC curve were used to draw the statistical inferences. Results: Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm, IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of catheter insertion. Conclusion: Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a significant problem. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>= 36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 - 40 years. Therefore more attention and care are needed in these areas by the care provider. Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal. doi: 10.3126/kumj.v6i4.1732 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 443-447

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Improving outcomes of short peripheral vascular access in oncology and chemotherapy administration

The Journal of Vascular Access ◽

10.5301/jva.5000668 ◽

2017 ◽

Vol 18 (2) ◽

pp. 89-96 ◽

Cited By ~ 8

Author(s):

Sergio Bertoglio ◽

Ton van Boxtel ◽

Godelieve A. Goossens ◽

Lisa Dougherty ◽

Rhoikos Furtwangler ◽

...

Keyword(s):

Vascular Access ◽

Best Practice ◽

Peripheral Vascular ◽

Intravenous Catheter ◽

Care Bundles ◽

Chemotherapy Administration ◽

Peripheral Intravenous Catheter ◽

Ongoing Care ◽

Oncology Practice ◽

To Receive

A short peripheral intravenous catheter or cannula (PIVC) is frequently used to deliver chemotherapy in oncology practice. Although safe and easy to insert, PIVCs do fail, leading to personal discomfort for patients and adding substantially to treatment costs. As the procedure of peripheral catheterization is invasive, there is a need for greater consistency in the choice, insertion and management of short PIVCs, particularly in the oncology setting where there is a growing trend for patients to receive many different courses of IV treatment over a number of years, sometimes with only short remissions. This article reviews best practice with respect to PIVCs in cancer patients and considers the necessity for bundling these actions. Two care bundles, addressing both insertion and ongoing care and maintenance, are proposed. These have the potential to improve outcomes with the use of short PIVCs for vascular access in oncology practice.

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Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial

Infection Control and Hospital Epidemiology ◽

10.1086/674398 ◽

2014 ◽

Vol 35 (1) ◽

pp. 63-68 ◽

Cited By ~ 124

Author(s):

Marianne C. Wallis ◽

Matthew McGrail ◽

Joan Webster ◽

Nicole Marsh ◽

John Gowardman ◽

...

Keyword(s):

Risk Factors ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Secondary Analysis ◽

Secondary Data ◽

Intravenous Catheter ◽

Antecubital Fossa ◽

Randomized Controlled ◽

Increased Risk ◽

Peripheral Intravenous Catheter

Objective.To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.Methods.Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.Setting.Three acute care hospitals in Queensland, Australia.Participants.The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.Results.Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).Conclusions.PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.Trial Registration.The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).

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Phlebitis associated with peripheral intravenous catheters and nursing carePeriferik intravenöz kateterle ilişkili flebit ve hemşirelik bakımı

Journal of Human Sciences ◽

10.14687/jhs.v13i2.3674 ◽

2016 ◽

Vol 13 (2) ◽

pp. 2905 ◽

Cited By ~ 2

Author(s):

Dilek Sarı ◽

İsmet Eşer ◽

Ayşe Akbıyık

Keyword(s):

Risk Factors ◽

Intravenous Catheter ◽

Duration Of Hospitalization ◽

Peripheral Intravenous Catheter ◽

Catheter Size ◽

The Cost ◽

Systemic Infections ◽

Intravenous Catheters ◽

Intravenous Medication ◽

Tunica Intima

Phlebitis, defined as inflammation of the tunica intima, is most important of complications associated with peripheral intravenous catheters and, occurs between 0.1% and 63.3% of patients with peripheral intravenous catheter. Phlebitis can be originated mechanical, chemical and, bacterial. Whatever the reason, phlebitis extends the duration of hospitalization, raise the cost of treatment, causes bacteremia. There are reported to be effective some factors such as type of catheter material, catheter size, dwell time of catheterisation, anatomical region used for catheterisation, health personnel’s ability to place the catheter, liquid flow rate, using infusion pumps, number of intravenous medication, on the development of mechanical phlebitis. Chemical phlebitis, developes due to characteristics such as pH and osmolarity of the drug and fluid infused which caused irritation of the endothelial layer through the cannula. Bacterial phlebitis, which is occured a bacterial infection of vein intima, can be a source of serious systemic infections including bacteremia. As a result, phlebitis is a complication of intravenous application, can be avoided as long as working in accordance with certain principles. The risk development of phlebitis can be minimized, in case of compliance with the standards during peripheral intravenous catheter insertion and throughout of catheterization. In this article was focused on phlebitis definition, epidemiology, risk factors and prevention of the development phlebitis for risk factors and patient care with phlebitis. ÖzetVenin tunika intima tabakasının enflamasyonu olarak tanımlanan flebit, periferik intravenöz kateterlerle ilişkili komplikasyonların en önemlisi olup, periferik intravenöz kateter takılan hastaların %0.1-%63.3’ünde görülmektedir. Flebit mekanik, kimyasal ve bakteriyel kaynaklı olabilir. Flebit nedeni ne olursa olsun hastaların yatış süresini uzatmakta, tedavi maliyetini yükseltmekte ve bakteriyemiye neden olmaktadır. Kateter materyalinin tipi, kateteterin boyutu, kateterin vende kalış süresi, kullanılan anatomik bölge, kateteri yerleştiren kişinin becerisi, sıvı akış hızı, infüzyon pompalarının kullanımı, verilen ilaçların sayısı gibi faktörlerin mekanik flebit oluşumunda etkili olduğu bildirilmektedir. Kimyasal flebit, kanül boyunca infüze edilen ilaç ve sıvıların pH’sı ve osmolaritesi gibi özelliklerinden dolayı venin endoteyal katmanını tahriş etmesi sonucunda gelişir. Ven intimasının bakteriyel enfeksiyonu sonucu gelişen bakteriyel flebit bakteriyemi gibi ciddi sistemik enfeksiyonların kaynağı olabilmektedir. Sonuç olarak, flebit belirli ilkelere uygun çalışıldığında intravenöz uygulamaların önlenebilir bir komplikasyonudur. Periferik intravenöz kateter takma ve izlem sırasında belirlenen standartlara uyulma hassasiyeti gösterildiği taktirde flebit gelişimi minimize edilebilir. Bu makalede, flebitin tanımı, epidemiyolojisi, risk faktörleri ve risk faktörlerine yönelik flebit gelişimini önleme önerileri ve flebit gelişen hastanın bakımı üzerinde odaklanılmıştır.

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