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Updated: May 29, 2025
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Differences in catheter-related complications to insertion site selection for long peripheral intravenous catheters
Linfang Zhao1, Xianghong Jin1, Xiangyun Li1
1Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Background:
The long peripheral intravenous catheter (long PIVC), a type of PIVC, has an indwelling time of 5-14 days and is one of the options for antibacterial therapy. However, there is no consensus regarding the impact of insertion site selection on the complications associated with long PIVCs.
Methods:
This randomized controlled trial included 90 participants randomly assigned to either the control or experimental group, with 45 patients in each group. In the control group, long PIVCs were placed in the forearm, while in the experimental group, they were inserted in the upper arm. The primary outcome was catheter-related complications, while secondary outcomes included the first-attempt insertion success rate, total procedure time, and indwelling catheter duration.
Results:
The incidence of catheter-related complication rates was significantly lower in the experimental group (25.0%) compared to the control group (66.7%) (χ2 = 14.528, P < 0.001). The median indwelling catheter duration (interquartile range [IQR]) in the experimental and control groups were 187 [129, 286] hours and 122 [96, 188] hours, respectively, and the difference was statistically significant (Z = 3.016, P < 0.001). The first-attempt insertion success rates were comparable between the experimental group (97.7%) and the control group (97.4%). Similarly, the median total procedure times (IQR) in the experimental and control groups were 5.55 [4.93, 7.48] minutes and 6.17 [5.00, 7.33] minutes, showed no statistically significant difference (Z = 0.511, P > 0.05).
Conclusions:
Selecting the upper arm as the insertion site for long PIVCs reduced the incidence of thrombophlebitis and extended indwelling catheter duration during antimicrobial therapy.
Trial Registration:
ClinicalTrials.gov identifier: NCT06455228 (Initial Release: 05/30/2024).
Insights
Choosing the upper arm for long peripheral intravenous catheters (long PIVCs) significantly reduces complications and extends catheter dwell time. This insertion site improves patient outcomes during antibacterial therapy.
Area of Science:
- Vascular Access Devices
- Infectious Disease Management
- Clinical Trials
Background:
- Long peripheral intravenous catheters (long PIVCs) are crucial for antibacterial therapy, but optimal insertion site selection remains debated.
- Current evidence lacks consensus on how insertion site impacts long PIVC-related complications.
Purpose of the Study:
- To evaluate the impact of upper arm versus forearm insertion on complications associated with long PIVCs.
- To compare catheter-related complications, insertion success rates, procedure times, and indwelling duration between the two insertion sites.
Main Methods:
- A randomized controlled trial involving 90 participants was conducted.
- Participants were randomized into two groups: forearm (control) or upper arm (experimental) insertion of long PIVCs.
- Primary outcome was catheter-related complications; secondary outcomes included insertion success, procedure time, and dwell duration.
Main Results:
- The experimental group (upper arm) showed significantly lower complication rates (25.0%) compared to the control group (66.7%) (P < 0.001).
- Indwelling catheter duration was significantly longer in the upper arm group (median 187 hours) versus the forearm group (median 122 hours) (P < 0.001).
- First-attempt insertion success rates (97.7% vs 97.4%) and total procedure times were comparable between groups.
Conclusions:
- Upper arm insertion for long PIVCs significantly reduces catheter-related complications, particularly thrombophlebitis.
- This site selection also extends the indwelling catheter duration, enhancing antimicrobial therapy effectiveness.
- The findings support the upper arm as a preferred insertion site for long PIVCs.
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