Full title: peripheral venous catheter complications in children: predisposing factors in a multicenter prospective cohort study

BMC Pediatrics

Research Article

Habiba Hafsi¹  Hela Hajji¹  Hela Boudabous²  Amel Ben Chehida²  Néji Tebib²  Hatem Azzouz²  Rim Ben Abdelaziz³  Mourad Hamzaoui⁴  Azza Sammoud⁵  Khadija Boussetta⁶  Ali Mrabet⁷  Sihem Barsaoui⁸ 

[1] Department of Pediatrics, La Rabta Hospital, Tunis, Tunisia;Department of Pediatrics, La Rabta Hospital, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Military General Directorate of Health, department of Epidemiology and Public Health, Tunis, Tunisia;Department of Pediatrics, La Rabta Hospital, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Military General Directorate of Health, department of Epidemiology and Public Health, Tunis, Tunisia;Department of Pediatrics, La Rabta Hospital Jabbari, 1007, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Department of Pediatrics, La Rabta Hospital Jabbari, 1007, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Department of Pediatric Surgery A, Hôpital d’enfants Béchir Hamza de Tunis, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Department of Pediatrics A, Hôpital d’enfants Béchir Hamza de Tunis, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Department of Pediatrics B, Hôpital d’enfants Béchir Hamza de Tunis, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, Tunis, Tunisia;Université Tunis El Manar, Faculté de Médecine de Tunis; Department of Pediatrics C, Hôpital d’enfants Béchir Hamza de Tunis, Tunis, Tunisia;

关键词: Peripheral venous catheter;    Children;    Complication;    Extravasation;    Lifespan;    Prevention;   

DOI  :  10.1186/s12887-017-0965-y

 received in 2017-03-20, accepted in 2017-12-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPeripheral venous catheterization (PVC) is frequently used in children. This procedure is not free from potential complications. Our purpose was to identify the types and incidences of PVC complications in children and their predisposing factors in a developing country.MethodsWe conducted a prospective observational multicenter study in five pediatric and pediatric surgery departments over a period of 2 months. Two hundred fifteen PVC procedures were conducted in 98 children. The times of insertion and removal and the reasons for termination were noted, and the lifespan was calculated. Descriptive data were expressed as percentages, means, standard deviations, medians and interquartile ranges. The Chi2 test or the Fisher test, with hazard ratios and 95% confidence intervals (CI95%), as well as Student’s t test or the Mann-Whitney U test were used to compare categorical and quantitative variables, respectively, in groups with and without complications. The Spearman test was used to determine correlations between the lifespan and the quantitative variables. The Kruskal Wallis test was used to test for differences in the median lifespan within 3 or more subgroups of a variable. Linear regression and logistic binary regression were used for multivariate analysis. A p-value <0.05 was considered significant.ResultsThe mean lifespan was 68.82 ± 35.71 h. A local complication occurred in 111 PIVC (51.9%) cases. The risk factors identified were a small catheter gauge (24-gauge) (p = 0.023), the use of a volume-controlled burette (p = 0.036), a longer duration of intravenous therapy (p < 0.001), a medical diagnosis of respiratory or infectious disease (p = 0.047), the use of antibiotics (p = 0.005), including cefotaxime (p = 0.024) and vancomycin (p = 0.031), and the use of proton pump inhibitors (p = 0.004).The lifespan of the catheters was reduced with the occurrence of a complication (p < 0.001), including the use of 24-gauge catheters (p = 0.001), the use of an electronic pump or syringe(p = 0.036) and a higher rank of the intravenous device in each patient (p = 0.010).ConclusionsPVC complications were frequent in our pediatric departments and are often associated with misuse of the device. These results could engender awareness among both doctors and nurses regarding the need for rationalization of the use of PVC and better adherence to the recommendations for the use of each drug and each administration method.

【 授权许可】

CC BY   
© The Author(s). 2017