Fibroblastic sleeve and short peripheral catheter failures: Impact of risk factors

Short peripheral catheters (SPC) are commonly used in hospitalized patients to provide vascular access for short-term intravenous therapies. However, complications such as infection, thrombophlebitis, and fibroblastic sleeve formation can lead to premature catheter failure, negatively impacting patient care and increasing healthcare costs.

This study aims to identify risk factors associated with fibroblastic sleeve formation and evaluate their role in SPC failure, thereby supporting improved risk stratification and catheter management.

This is a secondary analysis of a prospective observational study involving 200 devices, monitored daily with ultrasound to detect complications, including fibroblastic sleeves. Patient-related and therapy-related risk factors were analyzed using univariate and multivariate Cox models to identify predictors of fibroblastic sleeve formation and device failure.

Of the 200 catheters, 94 (47%) developed fibroblastic sleeves detectable by ultrasound. In multivariate analysis, antibiotic therapy requiring central venous access was the only independent predictor of its formation (p = 0.03; HR, 2.09; 95% CI, 1.08-4.03). Risk factors independently associated with failure included older age, diabetes, cancer, bedridden status, use of antibiotics requiring central access, and omeprazole infusion.

Antibiotic infusion through short peripheral catheters was identified as a key risk factor for fibroblastic sleeve formation, while patient-related factors and specific therapies were associated with catheter failure. These findings underscore the importance of selecting and monitoring devices carefully in high-risk patients to minimize complications and enhance vascular access outcomes.