Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T01:37:57.205Z Has data issue: false hasContentIssue false
  • English
  • Français

Safety of Peripheral Intravenous Catheters in Children

Published online by Cambridge University Press:  02 January 2015

Ruth B. Shimandle ,
Daniel Johnson ,
Mark Baker ,
Naomi Stotland ,
Theodore Karrison  and
Paul M. Arnow
Ruth B. Shimandle
Affiliation:
Infection Control Program, University of Chicago Hospital, Chicago, Illinois
Daniel Johnson
Affiliation:
Department of Pediatrics, the University of Chicago, Chicago, Illinois
Mark Baker
Affiliation:
Pritzker School of Medicine, the University of Chicago, Chicago, Illinois
Naomi Stotland
Affiliation:
Pritzker School of Medicine, the University of Chicago, Chicago, Illinois
Theodore Karrison
Affiliation:
Department of Health Studies, the University of Chicago, Chicago, Illinois
Paul M. Arnow*
Affiliation:
Infection Control Program, University of Chicago Hospital, Chicago, Illinois Department of Medicine, the University of Chicago, Chicago, Illinois
*
Infection Control Program, MC 5065, University of Chicago Hospital, 5841 Maryland Ave, Chicago, IL 60637
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To determine the overall and per-day risk of complications of short peripheral intravenous (PIV) catheters placed for indefinite periods.

Design:

During 5 months, general pediatric patients receiving intravenous therapy through short PIV catheters were monitored. Patient and catheter characteristics were recorded, complications were noted, and rolled semiquantitative cultures of removed catheters were performed. Major endpoints were infection and phlebitis. Per-day risk of complications and catheter colonization (>15 colony-forming units) were calculated.

Setting:

University children's hospital.

Patients:

General pediatric ward inpatients with PIV.

Results:

We studied 642 Teflon catheters in place >24 hours (mean, 3.7 days) in 525 patients. There were no cases of catheter sepsis (0%; 95% confidence interval [CI95], 0%-0.6%), one possible insertion-site infection (0.2%; CI95, 0.004%-0.9%), and seven cases of phlebitis (1.1%; CI95, 0.4%-2.3%). Catheter colonization occurred in 92 (26%) of 348 catheters cultured. Neither the per-day risk of phlebitis nor of catheter colonization increased significantly with placement >3 days.

Conclusion:

Current guidelines recommend replacement of PIV catheters in adults within 2 to 3 days; no recommendations are made for children. Our findings and those of others indicate that the overall risk of PIV catheter complications in children is extremely low and would not be reduced substantially by routine catheter replacement.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 11 , November 1999 , pp. 736 - 740
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Damen, J, Van der Tweel, I. Positive tip cultures and related risk factors associated with intravascular catheterization in pediatric cardiac patients. Crit Care Med 1988;16:221–228.Google Scholar
2. Nelson, DB, Garland, JS. The natural history of Teflon catheter-associated phlebitis in children. Am J Dis Child 1987;141:1090–1092.Google Scholar
3. Tully, JL, Friedland, GH, Baldini, LM, Goldmann, D. Complications of intravenous therapy with steel needles and Teflon catheters. A comparative study. Am J Med 1981;70:702–706.Google Scholar
4. Raad, II, Bodey, GP. Infectious complications of indwelling vascular catheters. Clin Infect Dis 1992;15:197–208.Google Scholar
5. Garland, JS, Nelson, DB, Cheah, TE, Hennes, HH, Johnson, TM. Infectious complications during peripheral intravenous therapy with Teflon catheters: a prospective study. Pediatr Infect Dis J 1987;6:918–921.Google Scholar
6. Garland, JS, Dunne, W Jr, Havens, P, Hintermeyer, M, Bozzette, MA, Wincek, J, et al. Peripheral intravenous catheter complications in critically ill children: a prospective study. Pediatrics 1992;89(6 Pt 2): 1145–1150.CrossRefGoogle ScholarPubMed
7. Batton, DG, Maiseis, MJ, Appelbaum, P. Use of peripheral intravenous cannulas in premature infants: a controlled study. Pediatrics 1982;70:487–490.Google Scholar
8. Band, JD, Maki, DG. Steel needles used for intravenous therapy. Morbidity in patients with hematologic malignancy. Arch Intern Med 1980;140:31–34.Google Scholar
9. Maki, DG, Ringer, M. Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent Polyurethane dressing, and an iodophor-transparent dressing. JAMA 1987;258:2396–2403.CrossRefGoogle Scholar
10. Craven, DE, Lichtenberg, D. Kunches, LM, McDonough, AT, Gonzalez, MI, Heeren, TC, et al. A randomized study comparing a transparent Polyurethane dressing to a dry gauze dressing for peripheral intravenous catheter sites. Infect Control 1985;6:361–366.Google Scholar
11. Tager, IB, Ginsberg, MB, Ellis, SE, Walsh, NE, Dupont, I, Simchen, E, et al. An epidemiologic study of the risks associated with peripheral intravenous catheters. Am J Epidemiol 1983;118:839–851.Google Scholar
12. Maki, DG, Ringer, M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. A randomized controlled trial. Ann Intern Med 1991;114:845–854.Google Scholar
13. Centers for Disease Control and Prevention. Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol 1996;17:438–473.Google Scholar
14. Maki, DG, Weise, CE, Sarafin, HW. A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 1977;296:1305–1309.CrossRefGoogle ScholarPubMed
15. Murray, PR, Baron, EJ, Pfaller, M. Tenover, FC, Yolken, RH, eds. Manual of Clinical Microbiology. 6th ed. Washington, DC: ASM Press; 1995.Google Scholar
16. Breslow, NE, Day, NE. Statistical Methods in Cancer Research, Vol 2—The Design and Analysis of Cohort Studies. London, England: IARC Scientific Publications; 1987:131–135.Google Scholar
17. Zeger, SL, Liang, KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics 1986;42:121–130.Google Scholar
18. Schlager, T. Hidde, M, Rodger, P, Germanson, TP, Donowitz, LG. Intravascular catheter colonization in critically ill children. Infect Control Hosp Epidemiol 1997;18:347–348.Google Scholar
19. Garland, JS, Buck, RK, Maloney, P, Durian, DM, Toth-Lloyd, S, Duffy, M, et al. Comparison of 10% povidone-iodine and 0.5% Chlorhexidine gluconate for the prevention of peripheral intravenous catheter colonization in neonates: a prospective trial. Pediatr Infect Dis J 1995;14:510–516.Google Scholar
20. Hershey, CO, Tomford, JW, McLaren, CE, Porter, DK, Cohen, DI. The natural history of intravenous catheter-associated phlebitis. Arch Intern Med 1984;144:1373–1375.CrossRefGoogle ScholarPubMed
21. Centers for Disease Control Working Group. Guidelines for prevention of intravenous therapy-related infections. Infect Control 1981;3:62–79.Google Scholar
22. Bentley, DW, Lepper, MH. Septicemia related to indwelling venous catheter. JAMA 1968;206:1749–1752.Google Scholar
23. Harbin, RL, Schaffner, W. Septicemia associated with scalp-vein needles. South Med J 1973;66:638–640.Google Scholar
24. Maki, DG, Band, JD. A comparative study of polyantibiotic and iodophor ointments in prevention of vascular catheter-related infection. Am J Med 1981;70:739–744.Google Scholar