Drug Extravasation in a Tertiary Referral Children Hospital: A Prospective Cohort Study

Area of Science:

• Pediatric critical care medicine
• Vascular access complications
• Patient safety in pediatrics

Background:

• Extravasation injuries are common in pediatric hospitals, leading to significant tissue damage and prolonged hospital stays.
• Limited data exists on specific risk factors contributing to extravasation in pediatric patients.
• Intravenous (IV) therapy is a common procedure in pediatric care, necessitating an understanding of associated risks.

Purpose of the Study:

• To identify and analyze the risk factors associated with extravasation injuries in pediatric patients undergoing IV therapy.
• To provide data that can inform preventative strategies and improve patient safety in pediatric intensive care units.
• To investigate the relationship between patient demographics, catheterization methods, and extravasation events.

Main Methods:

• A prospective cohort study involving 500 pediatric patients (1 month to 18 years) admitted to the pediatric intensive care unit (PICU).
• Data collection included patient demographics, catheter type (central vs. peripheral), duration of hospitalization, drug administration, and extravasation occurrences.
• Statistical analysis was performed to determine significant associations between potential risk factors and extravasation events.

Main Results:

• The overall prevalence of extravasation was 9.8% (49 out of 500 patients).
• Significant risk factors identified include female gender (P = .002), central venous catheterization (P = .002), prolonged hospitalization (P < .001), reduced consciousness (P = .012), and the use of taping for vein fixation (P = .004).
• The median age of participants was 36 months, with 56% being male.

Conclusions:

• Female gender, central venous catheterization, extended hospitalization, decreased consciousness, and taping for vein fixation are significant risk factors for extravasation in pediatric patients.
• Healthcare providers must proactively assess these risk factors to minimize the incidence and severity of extravasation injuries.
• Implementing targeted preventative measures based on identified risk factors is essential for improving outcomes in vulnerable pediatric populations receiving IV therapy.