Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Area of Science:

• Vascular Access
• Medical Device Insertion
• Patient Safety

Background:

• Difficult peripheral intravenous cannulation (DPIVC) can lead to serious vascular access complications.
• Identifying risk factors for DPIVC is essential for early detection and prevention.
• Understanding these factors can improve patient outcomes and reduce healthcare-associated risks.

Purpose of the Study:

• To identify independent risk factors for DPIVC.
• To determine the influence of hospital setting on DPIVC occurrence.
• To examine the association between DPIVC, catheter insertion techniques, and clinician experience.

Main Methods:

• A case-control study was conducted in 48 units across eight Spanish public hospitals.
• 2662 adult patients requiring peripheral intravenous cannulation were prospectively enrolled.
• Data on vascular access, insertion techniques, and patient/clinician variables were collected and analyzed using logistic regression.

Main Results:

• 8.3% of patients (221) experienced DPIVC.
• Independent risk factors identified include: previous difficulty, non-palpable veins, acute upper limb alterations, and ante-cubital fossa punctures.
• DPIVC frequency and risk factors varied by healthcare context; clinician experience did not significantly influence outcomes.

Conclusions:

• Four independent risk factors for DPIVC were identified.
• These factors can be integrated into algorithms for DPIVC prevention.
• Facilitating referral to specialist vascular access teams is a key implication for clinical practice.