Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial.
Derdried Athanasio Johann, Mitzy Tannia Reichembach Danski, Stela Adami Vayego and 2 others
PMID 27901218WHAT IT FOUND
The two catheter types had no significant difference in overall complications.
Longer stay, antimicrobials, infusion of solutions and fluids, and corticosteroids raised risk; gauge 20 lowered it.
Key findings
01No statistically significant difference was found between the integrated safety catheter and simple needle catheter groups for complications.
02Stay of 10 to 19 days increased complication risk by 1.36 and stay of 20 to 29 days by 1.61 compared with 1 to 9 days; gauge 20 reduced risk by 0.71, while antimicrobials and infusion of solutions and fluids increased risk by 1.33 and 1.32.
03Phlebitis risk increased by 2.43 when catheters remained beyond 72 hours, and seepage risk increased 6 times after a third successful puncture attempt.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Blinding was not possible because the catheters were physically different. Some venipuncture records were missing from patient charts, so data were partly recovered by ward searches and staff questions. Of 193 eligible patients, 15 were excluded from analysis and 9 refused or gave up, including 8 after randomization, leaving 169 patients. Rare complications were too few for univariate analysis: six local infections, one extravasation and one thrombophlebitis were left out. The study was done in a Brazilian university hospital among adults expected to stay more than 96 hours, so it may not apply to other settings or patients with shorter stays. The catheter comparison was a secondary analysis of a randomized trial, and the risk factor findings were secondary outcomes.
Declared interests
This research was supported by Brazil's CNPq, process #482886/2013-7. The paper was extracted from a doctoral dissertation.
The easy way to misread this
Do not conclude that the integrated safety catheter prevents complications. The primary complication comparison was not significant, and the cumulative risk curves did not differ significantly. The useful findings are associations with stay length, gauge, infusion type and insertion attempts.