Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs
Simpson, S.E. and Zersen, K.M. (2022) Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs. Journal of Small Animal Practice.
The aim of this prospective, observational study was to report the incidence and type of peripheral intravenous catheter (PIVC) complications in dogs admitted to either the Intermediate Care Unit (IMCU) or the Critical Care Unit (CCU) at a veterinary teaching hospital in the United States.
Dogs hospitalised in the IMCU or CCU ward between November 2020 and March 2021 that had a short PIVC in place for more than 24 hours and that had received intravenous fluids, were eligible for inclusion in the study. All PIVCs had been placed following a standard institutional protocol. The PIVCs were monitored for complications at least three times daily. Confirmed complications were documented and classified as extravasation, phlebitis, dislodgement, occlusion or line breakage. Phlebitis was graded (0-5) using the Visual Infusion Phlebitis Scale.
A total of 396 dogs were enrolled in the study, 240 in the CCU and 156 in the IMCU. There were 412 PIVCs placed during the study period, 252 CCU and 160 in IMCU. The overall incidence of complications was 82 (19.9%), 61 (24.2%) in the CCU and 21 (13.1%) in the IMCU. The most common complication in the CCU was phlebitis, and in the ICMU it was line breakage. The incidence of phlebitis and extravasation were significantly higher in the CCU than in the IMCU. There was no significant difference in the incidence of dislodgement, occlusion, or line breakage between the two wards. Patient weight and length of hospital stay had a significant effect on the likelihood of PIVC complication.
Limitations of the study are that the PIVCs were placed by a variety of individuals with different levels of experience, the possibility of errors occurring in the identification and recording of complications and that a number of potential risk factors including illness severity and gauge and location of catheters were not evaluated. The study did not document any cases of catheter-related infections, however as catheters were not cultured no conclusions can be drawn regarding incidence of catheter-related infections.
This study provides some evidence on the incidence and type of complications after placement of a PIVC which will help veterinary surgeons assess their management protocols for PIVC placement.
Some evidence is provided on the risk factors for complications after placement of a PIVC but further research is needed on ways to mitigate these risks as well as on the incidence of catheter-related infections.
The following may also be of interest:
Peripheral catheter care and phlebitis score [RCVS Knowledge][online]. Available from: https://knowledge.rcvs.org.uk/document-library/peripheral-catheter-care-and-phlebitis-score/ [Accessed 20 February 2023]
Peripheral catheter checklist and audit case example [RCVS Knowledge][online]. Available from: https://knowledge.rcvs.org.uk/document-library/peripheral-catheter-checklist-and-audit-case-example/ [Accessed 20 February 2023]
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