Occurrence and Incidence Rate of Peripheral Intravascular Catheter-related Phlebitis and Complications in Critically Ill Patients: a Prospective Cohort Study (AMOR-VENUS Study)

Overview

Journal J Intensive Care

Publisher Biomed Central

Specialty Critical Care

Date 2021 Jan 7

PMID 33407891

Citations 10

Authors

Hideto Yasuda

Ryohei Yamamoto

Yoshiro Hayashi

Yuki Kotani

Yuki Kishihara

Natsuki Kondo

Kosuke Sekine

Nobuaki Shime

Keita Morikane

Takayuki Abe

Toru Takebayashi

Mikihiro Maeda

Takuya Shiga

Taku Furukawa

Mototaka Inaba

Sachito Fukuda

Kiyoyasu Kurahashi

Sarah Murakami

Yusuke Yasumoto

Tetsuro Kamo

Masaaki Sakuraya

Rintaro Yano

Toru Hifumi

Masahito Horiguchi

Izumi Nakayama

Masaki Nakane

Kohei Ota

Tomoaki Yatabe

Masataka Yoshida

Maki Murata

Kenichiro Fujii

Junki Ishii

Affiliations

Soon will be listed here.

Abstract

Background: The lack of precise information on the epidemiology of peripheral intravascular catheter (PIVC)-related phlebitis and complications in critically ill patients results in the absence of appropriate preventive measures. Therefore, we aimed to describe the epidemiology of the use of PIVCs and the incidence/occurrence of phlebitis and complications in the intensive care unit (ICU).

Methods: This prospective multicenter cohort study was conducted in 23 ICUs in Japan. All consecutive patients aged ≥ 18 years admitted to the ICU were enrolled. PIVCs inserted prior to ICU admission and those newly inserted after ICU admission were included in the analysis. Characteristics of the ICU, patients, and PIVCs were recorded. The primary and secondary outcomes were the occurrence and incidence rate of PIVC-related phlebitis and complications (catheter-related blood stream infection [CRBSI] and catheter failure) during the ICU stay.

Results: We included 2741 patients and 7118 PIVCs, of which 48.2% were inserted in the ICU. PIVC-related phlebitis occurred in 7.5% (95% confidence interval [CI] 6.9-8.2%) of catheters (3.3 cases / 100 catheter-days) and 12.9% (95% CI 11.7-14.2%) of patients (6.3 cases / 100 catheter-days). Most PIVCs were removed immediately after diagnosis of phlebitis (71.9%). Grade 1 was the most common phlebitis (72.6%), while grade 4 was the least common (1.5%). The incidence rate of CRBSI was 0.8% (95% CI 0.4-1.2%). In cases of catheter failure, the proportion and incidence rate per 100 intravenous catheter-days of catheter failure were 21% (95% CI 20.0-21.9%) and 9.1 (95% CI 8.7-10.0), respectively.

Conclusion: PIVC-related phlebitis and complications were common in critically ill patients. The results suggest the importance of preventing PIVC-related complications, even in critically ill patients.

Trial Registration: UMIN-CTR, the Japanese clinical trial registry (registration number: UMIN000028019 , July 1, 2017).

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