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Safety of Peripheral Intravenous Catheters in Children

Published online by Cambridge University Press:  02 January 2015

Ruth B. Shimandle ,
Daniel Johnson ,
Mark Baker ,
Naomi Stotland ,
Theodore Karrison  and
Paul M. Arnow
Ruth B. Shimandle
Affiliation:
Infection Control Program, University of Chicago Hospital, Chicago, Illinois
Daniel Johnson
Affiliation:
Department of Pediatrics, the University of Chicago, Chicago, Illinois
Mark Baker
Affiliation:
Pritzker School of Medicine, the University of Chicago, Chicago, Illinois
Naomi Stotland
Affiliation:
Pritzker School of Medicine, the University of Chicago, Chicago, Illinois
Theodore Karrison
Affiliation:
Department of Health Studies, the University of Chicago, Chicago, Illinois
Paul M. Arnow*
Affiliation:
Infection Control Program, University of Chicago Hospital, Chicago, Illinois Department of Medicine, the University of Chicago, Chicago, Illinois
*
Infection Control Program, MC 5065, University of Chicago Hospital, 5841 Maryland Ave, Chicago, IL 60637
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Abstract

Objectives:

To determine the overall and per-day risk of complications of short peripheral intravenous (PIV) catheters placed for indefinite periods.

Design:

During 5 months, general pediatric patients receiving intravenous therapy through short PIV catheters were monitored. Patient and catheter characteristics were recorded, complications were noted, and rolled semiquantitative cultures of removed catheters were performed. Major endpoints were infection and phlebitis. Per-day risk of complications and catheter colonization (>15 colony-forming units) were calculated.

Setting:

University children's hospital.

Patients:

General pediatric ward inpatients with PIV.

Results:

We studied 642 Teflon catheters in place >24 hours (mean, 3.7 days) in 525 patients. There were no cases of catheter sepsis (0%; 95% confidence interval [CI95], 0%-0.6%), one possible insertion-site infection (0.2%; CI95, 0.004%-0.9%), and seven cases of phlebitis (1.1%; CI95, 0.4%-2.3%). Catheter colonization occurred in 92 (26%) of 348 catheters cultured. Neither the per-day risk of phlebitis nor of catheter colonization increased significantly with placement >3 days.

Conclusion:

Current guidelines recommend replacement of PIV catheters in adults within 2 to 3 days; no recommendations are made for children. Our findings and those of others indicate that the overall risk of PIV catheter complications in children is extremely low and would not be reduced substantially by routine catheter replacement.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 11 , November 1999 , pp. 736 - 740
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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