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Risk factors affecting infiltration of peripheral venous lines in infants
Insights
Peripheral venous line (PVL) infiltrations occurred in 58% of infants within 40 hours. Factors like race, cannula type, and solution type influenced infiltration time, but not patient demographics or infusion device type.
Area of Science:
- Pediatrics
- Vascular Access
- Infusion Therapy
Background:
- Peripheral venous lines (PVLs) are crucial for administering fluids and medications to infants.
- Understanding factors influencing PVL infiltration is essential for improving patient care and reducing complications.
Purpose of the Study:
- To investigate the influence of 11 variables on the infiltration of PVLs in infants under one year of age.
- To identify risk factors and timeframes associated with PVL infiltration.
Main Methods:
- A prospective study of 151 infusions in infants younger than 1 year.
- Data collected on patient demographics, cannula characteristics, infusion solutions, and administration methods.
- Statistical analysis to determine the significance of various factors on infiltration occurrence and time.
Main Results:
- Fifty-eight percent of PVLs infiltrated, with a median time of 40 hours.
- Infiltration was more frequent in Black infants and those with lower solution head heights.
- Steel cannulas, intravenous medication administration, peripheral parenteral nutrition, and increasing cannula gauge were associated with decreased time to infiltration.
Conclusions:
- PVL infiltration is common in infants, with specific risk factors identified.
- Cannula material, medication administration, solution type, and cannula gauge significantly impact infiltration time.
- Further research may focus on strategies to mitigate these identified risks.
Abstract:
The influence of 11 variables on the infiltration of peripheral venous lines (PVLs) was evaluated during 151 infusions in patients younger than 1 year of age. Infusions were followed from the time of cannula placement to discontinuation. Fifty-eight percent of PVLs were infiltrated by 36.30 +/- 33.53 hours (mean +/- SD; median 40 hours, range 10 to 187 hours). No difference between infiltrated and noninfiltrated PVLs was noted with regard to patient age, gender, weight, cannula type, cannula gauge, cannula site, infusion device, potassium or dextrose concentration, medications, or rate of solution administration (P greater than 0.05). Infiltration was observed more often in black than in white infants (P = 0.03) and in patients with lower controller solution head heights (P = 0.01). The time to infiltration was decreased significantly for steel verus Teflon cannulas (P = 0.02), for administration of intravenous medication versus no administration of medication (P = 0.03), for peripheral parenteral nutrition solutions compared with 5% or 10% dextrose solutions (P = 0.014), and with increasing cannula gauge (P = 0.05). The time to infiltration did not differ significantly for gravity-controlled versus positive-pressure infusion device delivery (P = 0.51) or for potassium concentrations less than or equal to 20 mEq/L versus greater than 20 mEq/L (P = 0.13). Infusion device occlusion alarms were associated with only 19% of infiltrations. No sloughing of skin or necrosis of tissue occurred related to infiltration.