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Characteristics of Intravenous Fluid Infiltration and Factors Associated With Adverse Events: A Multicenter
Jessica L Duggan1, Aron Lechtig1, Ian T Watkins1
1Harvard Combined Orthopaedic Residency Program, Boston, MA, USA.
Hand (New York, N.Y.)
|December 13, 2024
Summary
Peripheral intravenous (PIV) infiltration poses risks. ICU admission and intubation status are linked to adverse events, aiding early risk stratification for better patient outcomes.
Area of Science:
- Medical Complications
- Patient Safety
- Intravenous Therapy
Background:
- Peripheral intravenous (PIV) infiltration and extravasation are frequent complications during intravenous fluid administration.
- Identifying risk factors for severe adverse events is crucial for timely surgical consultation.
Purpose of the Study:
- To investigate risk factors associated with major adverse events following PIV infiltration.
- To aid in risk stratification for patients requiring early surgical consultation.
Main Methods:
- Retrospective analysis of patients with documented PIV infiltration or extravasation events (2015-2022) at three academic hospitals.
- Major adverse events defined as full-thickness injury requiring operative management; minor events as superficial injury.
- Analysis of patient demographics, surgical consults, and outcomes.
Main Results:
- 160 patients included; average age 64.1 years. Major adverse events in 4.4%, minor in 11.3%.
- Intensive care unit (ICU) admission and current intubation status significantly associated with adverse events (P=.02, P=.03).
- Current intubation status significantly linked to operative management (P=.001).
Conclusions:
- ICU admission and intubation status are significant risk factors for adverse events post-PIV infiltration.
- Early identification of high-risk patients can be facilitated by characterizing these events.
- Further research needed on infiltration risks with different fluid types (vesicant vs. nonvesicant).
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