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Safety of peripheral intravenous catheters in children

R B Shimandle1, D Johnson, M Baker

  • 1Infection Control Program, University of Chicago Hospital, Illinois 60637-1470, USA.

Infection Control and Hospital Epidemiology
|December 2, 1999
PubMed

Insights

The risk of complications from peripheral intravenous (PIV) catheters in children is very low, even when left in place longer than three days. Routine replacement is not necessary for pediatric patients.

Area of Science:

  • Pediatric Medicine
  • Infectious Diseases
  • Vascular Access

Background:

  • Current guidelines recommend routine replacement of peripheral intravenous (PIV) catheters in adults every 2-3 days.
  • There are no specific recommendations for PIV catheter dwell times in pediatric patients.
  • Understanding the risk of complications associated with prolonged PIV catheter use in children is crucial for optimizing patient care.

Purpose of the Study:

  • To determine the overall and per-day risk of complications associated with short peripheral intravenous (PIV) catheters placed for indefinite periods in pediatric patients.
  • To evaluate the incidence of infection and phlebitis in relation to PIV catheter dwell time.
  • To assess the rate of catheter colonization and its correlation with complications.

Main Methods:

  • A prospective study was conducted over 5 months involving general pediatric inpatients receiving intravenous therapy via short PIV catheters.
  • Data collected included patient and catheter characteristics, complications, and semiquantitative cultures of removed catheters.
  • Major endpoints were infection and phlebitis; per-day risk of complications and catheter colonization were calculated.

Main Results:

  • 642 catheters in 525 pediatric patients were analyzed, with a mean dwell time of 3.7 days.
  • No cases of catheter sepsis were observed (0%). One insertion-site infection (0.2%) and seven cases of phlebitis (1.1%) were reported.
  • Catheter colonization occurred in 26% of cultured catheters, with no significant increase in the per-day risk of phlebitis or colonization beyond 3 days.

Conclusions:

  • The overall risk of PIV catheter complications in children is extremely low.
  • Routine replacement of PIV catheters in pediatric patients is unlikely to substantially reduce complication rates.
  • Findings support a less restrictive approach to PIV catheter replacement in children compared to adults.
Abstract

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