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Shamel S, Zarkesh MR. Acyclovir extravasation in a newborn: a case report. J Med Case Rep 2024; 18:271. [PMID: 38845030 PMCID: PMC11157697 DOI: 10.1186/s13256-024-04585-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE Extravasation of infused drugs is not a rare problem in medical practice. Acyclovir is a vesicant and an antiviral medication commonly used for young children. In the present study, we presented a neonate with soft tissue damage due to acyclovir extravasation. CASE REPORT A female newborn (Iranian, Asian) with gestational age 37+2 weeks and breech presentation was born by Cesarean delivery from a mother with a recent history of Herpes simplex virus (HSV) infection (Yas Women's Hospital, Tehran, Iran). Intravenous administration of acyclovir was initiated through a peripheral catheter inserted on the dorsal side of the left hand. A few minutes after the second dose, the patient showed a diffused firm swelling, local discoloration, and induration in the dorsum of the hand. The peripheral catheter was removed immediately. Hyaluronidase was injected subcutaneously in five different regions around the catheterization site. Intermittent limb elevation and cold compression (for 10 minutes) were applied. Serial follow-ups and examinations were performed hourly to check limb inflammation, ischemia, and compartment syndrome. The limb swelling and discoloration significantly improved 4 hours after the second dose of hyaluronidase. CONCLUSION Early diagnosis of acyclovir extravasation and immediate management could prevent severe complications in neonates. Further studies are needed to suggest a standard approach and treatment protocol for acyclovir extravasation.
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Affiliation(s)
- Shirin Shamel
- Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Sarv Ave., North Nejatolahi Street, Tehran, 1598718311, Iran
| | - Mohammad Reza Zarkesh
- Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Sarv Ave., North Nejatolahi Street, Tehran, 1598718311, Iran.
- Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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2
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Hirata I, Mazzotta A, Makvandi P, Cesini I, Brioschi C, Ferraris A, Mattoli V. Sensing Technologies for Extravasation Detection: A Review. ACS Sens 2023; 8:1017-1032. [PMID: 36912628 PMCID: PMC10043935 DOI: 10.1021/acssensors.2c02602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 03/14/2023]
Abstract
Peripheral intravenous catheters are administered for various purposes, such as blood sampling or the infusion of contrast agents and drugs. Extravasation happens when the catheter is unintentionally directed outside of the vein due to movement of the intravascular catheter, enhanced vascular permeability, or occlusion of the upstream vein. In this article, extravasation and its mechanism are discussed. Subsequently, the sensorized devices (e.g., single sensor and multimodal detection) to identify the extravasation phenomena are highlighted. In this review article, we have shed light on both physiological and engineering points of view of extravasation and its detection approaches. This review provides an overview on the most recent and relevant technologies that can help in the early detection of extravasation.
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Affiliation(s)
- Ikue Hirata
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Arianna Mazzotta
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
- The
Biorobotics Institute, Scuola Superiore
Sant’Anna, Pontedera 56025, Italy
| | - Pooyan Makvandi
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Ilaria Cesini
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
| | - Chiara Brioschi
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Andrea Ferraris
- IIT-Bracco
Joint Lab, Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Bracco
S.p.A., 20134 Milano, Italy
| | - Virgilio Mattoli
- Center for
Materials Interfaces, Istituto Italiano
di Tecnologia, 56025 Pontedera, Pisa, Italy
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3
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Giardina M, Barillà D, Crimi C, Arone A, Benedetto F, Lucanto C, Natoli R, Messina R, David A, Noto A. Ultrasound-guided placement of long peripheral cannula in children with cystic fibrosis. Pediatr Pulmonol 2022; 57:2060-2066. [PMID: 35574730 PMCID: PMC9545099 DOI: 10.1002/ppul.25978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/03/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The natural history of cystic fibrosis (CF) lung disease is a chronic deterioration of lung function with intermittent episodes of pulmonary infectious exacerbations (PExs). Reliable venous access is a milestone of effective management of such exacerbations, managed both in hospital and outpatient chronic therapy. The aim of our study was to analyze the feasibility of ultrasound-guided positioning of long peripheral catheters (LPC) as reliable midterm venous access in children affected by CF. METHODS In this single-center prospective study, over a 60-month period, we included paediatric CF subjects admitted with PExs and undergoing intravenous antibiotic treatment. LPCs were inserted in all participants by paediatric anaesthesiologists with ultrasound guide technique. Prospective data were collected assessing catheter positioning procedure and complications. RESULTS A total of 122 LPC insertions were performed in 55 CF children. Participants had a median age of 6.75 years (interquatile range: 3.7-13.5) at the time of catheter insertion. Implantation was successful on the first attempt in 86% of cases; 2 (1%) major insertion-related complications were reported. Eighty-eight percent of catheters were electively removed at the end of antibiotic therapy without any complication. Seven percent of the catheters were removed electively for occlusion and 2% for local dislodgment. CONCLUSIONS The results of the present study suggest that ultrasound-guided positioning of LPCs are safe alternative means of peripheral venous access in children with chronic diseases such as CF.
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Affiliation(s)
- Massimiliano Giardina
- Division of Anesthesia and Critical Care, A. O. U. Policlinico "G. Martino", Messina, Italy
| | - David Barillà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Vascular Surgery, Policlinico G. Martino, University of Messina, Messina, Italy
| | - Claudia Crimi
- Respiratory Medicine Unit, Policlinico "G. Rodolico-San Marco", University Hospital, Catania, Italy
| | - Amelia Arone
- IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Filippo Benedetto
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Vascular Surgery, Policlinico G. Martino, University of Messina, Messina, Italy
| | - Cristina Lucanto
- Regional Centre for Cystic Fibrosis, A. O. U. Policlinico G.Martino, Messina, Italy
| | - Rossella Natoli
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Roberto Messina
- Division of Anesthesia and Critical Care, A. O. U. Policlinico "G. Martino", Messina, Italy
| | - Antonio David
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Division of Anesthesia and Critical Care, University of Messina, Messina, Italy
| | - Alberto Noto
- Department of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi", Division of Anesthesia and Critical Care, University of Messina, Messina, Italy
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Fatores de risco para extravasamento em cateteres periféricos em crianças com câncer. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao005996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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5
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Santos LMD, Figueredo IB, Silva CSGE, Catapano UO, Silva BSM, Avelar AFM. Risk factors for infiltration in children and adolescents with peripheral intravenous catheters. Rev Bras Enferm 2022; 75:e20210176. [DOI: 10.1590/0034-7167-2021-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to estimate the incidence of infiltration and the factors associated with its occurrence in children and adolescents in the operative period and with peripheral intravenous catheters. Methods: a longitudinal and prospective study with children and adolescents using peripheral intravenous catheters, conducted at the surgical clinic unit of a pediatric hospital in Feira de Santana, State of Bahia, from April 2015 to December 2016. The study used Pearson’s chi-square and Fisher’s exact test for the analysis. It also applied multiple analyses using Poisson regression with robust variance. Results: the incidence of infiltration was 31.2% and was associated with female sex (RR=0.53; CI=[0.30-0.96]), non-eutrophic children (RR=2.27; CI=[1.25-4.20]), who used non-irritating and non-vesicant drugs (RR=1.72; CI=[1.03-2.87]), vesicant drugs (RR=1.84; CI=[1.05-3.22]) and irritating/vesicant electrolytes (RR=2.35; CI=[1.38-3.97]). Conclusions: the study suggests the development of strategies that will help in the prevention of this adverse event through the knowledge of the associated factors.
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6
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Santos LMD, Conceição TB, Silva CSGE, Tavares SS, Rocha PK, Avelar AFM. Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians. Rev Bras Enferm 2021; 75:e20200611. [PMID: 34669898 DOI: 10.1590/0034-7167-2020-0611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 06/27/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to evaluate the care practice adopted by nursing technicians before, during and after peripheral intravenous catheterization performed in hospitalized children. METHODS cross-sectional and descriptive research, carried out in a pediatric hospital in Bahia through non-participatory observation of peripheral intravenous catheterizations performed in children by nursing technicians. Data was collected through an instrument containing care related to the moments before, during and after insertion of the catheter, calculating absolute and relative frequencies, measures of central tendency and dispersion. RESULTS there were 31 nursing technicians, who performed care mainly before intravenous catheterization. Nonconformities were identified regarding hand hygiene, use of a disposable mask, selection of the catheter insertion site, antisepsis, stabilization and catheter coverage. CONCLUSIONS most of the precautions observed regarding peripheral intravenous catheterization are not in accordance with the standards of practice recommended by the national and international literature.
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Affiliation(s)
- Luciano Marques Dos Santos
- Universidade Estadual de Feira de Santana. Feira de Santana, Bahia, Brazil.,Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | | | | | - Sheilla Siedler Tavares
- Universidade Paulista. São Paulo, São Paulo, Brazil.,Universidade de Sorocaba. Sorocaba, São Paulo, Brazil
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Effect of Intravenous Infiltration Management Program on Peripheral Intravenous Catheter Success and Infiltration in Hospitalized Infants. J Nurs Care Qual 2021; 36:E44-E49. [PMID: 32826695 DOI: 10.1097/ncq.0000000000000511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Peripheral intravenous catheter (PIVC) insertion is the most frequently used method for intravenous (IV) treatment in pediatric patients. PURPOSE The aim of this study was to determine the effect of the Intravenous Infiltration Management Program on the success of PIVC insertion and infiltration in infants. METHODS The study was carried out using a quasi-experimental design with pretest-posttest control groups and included 750 PIVC procedures for 218 infants between 28 days and 12 months of age. RESULTS The program decreased the number of PIVC insertions per patient, although it was not statistically significant (P = .076) and had an impact on the success of the PIVC attempt (P < .001), first PIVC attempt (P < .001), PIVC dwell time, and early detection of infiltration (P < .001). CONCLUSION The program is effective in the success of the PIVC insertion process and early detection of infiltration.
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8
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Hackenberg RK, Kabir K, Müller A, Heydweiller A, Burger C, Welle K. Extravasation Injuries of the Limbs in Neonates and Children-Development of a Treatment Algorithm. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:547-554. [PMID: 34158148 DOI: 10.3238/arztebl.m2021.0220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/18/2020] [Accepted: 04/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hospitalized children and neonates very often receive intravenous treatment. There has not yet been any systematic study of the incidence of extravasation injuries in this age group. In a few studies of neonates in intensive care receiving intravenous treatment, incidence figures in the range of 18-46% have been reported; 2.4-4% sustain serious complications, such as necrosis and ulceration, that can lead over the long term to contractures, deformities, and impaired limb function due to unfavorable scarring. No guidelines currently exist for the care of pediatric extravasation injuries. METHODS This review is based on pertinent publications (from 1979 to June 2020) retrieved by a selective search in PubMed, as well as on experience from the authors' own institution. RESULTS In the absence of randomized controlled trials on the care of pediatric extravasation injuries, the available evidence is limited to small-scale comparative studies and case series. Conservative, medical, or surgical treatment can be used, depending on the volume of the extravasate, the nature of the substrate, and individual patient-related factors. It should first be determined whether the extravasated substance has no primary toxic properties or is a tissue irritant or a necrosis-inducing substance (vesicant). The skin and subcutaneous tissue should be examined for injury, coloration, swelling, capillary refill time, and pulses distal to the injury. Depending on the volume of the extravasate, the substrate, and the degree of tissue damage, the injury can be treated conservatively; medically, with the administration of an antidote, hyaluronidase, or a vasodilator such as phentolamine; or surgically, with multiple puncture procedures, washouts, or liposuction. CONCLUSION As there is no clear evidence that one form of treatment is superior to any other, the treatment of pediatric extravasation injuries remains an individual decision, with the known attendant risks of off-label treatment.
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9
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Santos LMD, Nunes KDJ, Silva CSGE, Kusahara DM, Rodrigues EDC, Avelar AFM. Elaboration and validation of an algorithm for treating peripheral intravenous infiltration and extravasation in children. Rev Lat Am Enfermagem 2021; 29:e3435. [PMID: 34190937 PMCID: PMC8253344 DOI: 10.1590/1518-8345.4314.3435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to elaborate and validate the content and appearance of an algorithm for treating infiltration and extravasation of non-chemotherapy drugs and solutions administered to children. METHOD a methodological study of the technology formulation and validation type. To elaborate the algorithm, a bibliographic review was carried out to list the scientific evidence on the treatment of infiltration and extravasation. Content and appearance validation was in charge of 14 specialists in pediatric nursing, using the Delphi technique, adopting a value equal to or greater than 0.80 as Content Validation Index. RESULTS the algorithm was validated in the third evaluation by the judges, reaching a Global Content Validation Index of 0.99, being composed by the perception of the occurrence of the complication; discontinuation of intravenous therapy infusion; verification of signs and symptoms; measurement of edema; application of an infiltration and extravasation assessment scale and conduits to be used according to the characteristics of the fluid administered and the type of complication. CONCLUSION the algorithm was validated and can be used in a practical and objective way by health professionals, in order to promote safety in the care of hospitalized children, with regard to reducing harms caused by infiltration and extravasation.
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Affiliation(s)
- Luciano Marques Dos Santos
- Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana, BA, Brazil.,Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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10
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Lu H, Yang Q, Nor HM, Lv Y, Zheng X, Xin X, Feng A, Sun Y, Zhou X, Zhang L, Qu Y, Li J, Guo X, Yang Y, Jiao J, Xie N. The safety of clinically indicated replacement or routine replacement of peripheral intravenous catheters: A randomized controlled study. J Vasc Access 2021; 23:436-442. [PMID: 33706602 DOI: 10.1177/1129729821998528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The primary purpose of this study was to explore the safety of peripheral intravenous catheter (PIVC) replacement every 96 h compared to that of clinically indicated catheter removal. METHODS A prospective, single-blind, randomized controlled trial was conducted. A random number table method was used. Six hundred patients treated with PIVC intravenous infusion in 10 nursing units of a hospital from September to October 2019 were selected. Sixty were collected from each nursing unit, including 30 in the clinically indicated replacement group and 30 in the routine replacement group. The incidence of phlebitis, catheter-related infection (CRI), occlusion, infiltration, and any form of infusion therapy failure were compared between the two groups. SPSS 23.0 software was used. RESULTS The dwelling times of PIVC in the clinically indicated replacement group and routine replacement group were significantly different (hours) (83.62 ± 50.08, 69.75 ± 25.54, t = 3.021, p = 0.003). The incidence of any form of infusion therapy failure (RR = 4.448, 95% CI: 3.158-6.265, p < 0.001), phlebitis (RR = 2.416, 95% CI: 1.595-3.660, p < 0.001), occlusion (RR = 6.610, 95% CI: 3.062-14.268, p < 0.001), infiltration (RR = 2.607, 95% CI: 1.130-6.016, p = 0.020), accidental dislodgement (RR = 2.027, 95% CI: 1.868-2.200, p = 0.013), and pain at the insertion site (RR = 2.521, 95% CI: 1.742-3.649, p < 0.001) was higher in the clinically indicated replacement group than that in the routine replacement group. The overall survival curve of PIVC was drawn with Kaplan-Meier survival analysis. The median survival time of intravenous infusion was 59.58 h; the cumulative survival rates of 48 h, 72 h, and 96 h were 77.00%, 51.33%, and 20.33%, respectively. CONCLUSION Replacement of PIVC every 96 h is safer than clinically indicated.
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Affiliation(s)
- Huapeng Lu
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Qinling Yang
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Hilal Mohamed Nor
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Yi Lv
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Xuemei Zheng
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Xia Xin
- Department of Nursing, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Aifang Feng
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Yali Sun
- Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Xiaoling Zhou
- Department of Orthopaedics, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Li Zhang
- Department of Gastroenterology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Yan Qu
- Department of Neurology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Juanli Li
- Cardiovascular Medicine Department, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Xiaoye Guo
- Department of Neurosurgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Yali Yang
- Department of Nephrology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Jianfang Jiao
- Department of Thoracic Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | - Na Xie
- Department of Urology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
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Chan KM, Chau JPC, Choi KC, Fung GPG, Lui WW, Chan MSY, Lo SHS. Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design. BMC Pediatr 2020; 20:445. [PMID: 32967637 PMCID: PMC7510280 DOI: 10.1186/s12887-020-02346-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/15/2020] [Indexed: 01/08/2023] Open
Abstract
Background Extravasation injury resulting from intravenous therapies delivered via peripheral intravenous catheters or umbilical and peripherally inserted central venous catheters is a common iatrogenic complication occurring in neonatal intensive care units. This study aimed to evaluate the effectiveness of an evidence-based clinical practice guideline in the prevention and management of neonatal extravasation injury by nurses. Methods A controlled before-and-after study was conducted in a neonatal unit. The clinical practice guideline was developed, and a multifaceted educational program was delivered to nurses. Neonatal outcomes, including the rates of peripheral intravenous extravasation and extravasation from a central line, were collected at the pre- and post-intervention periods. Post-intervention data for nurses, including the nurses’ level of knowledge and adherence, were collected at six months after the program. Results 104 and 109 neonates were recruited in the pre-intervention period (control) and the post-intervention period (intervention), respectively. The extravasation rate before and after the intervention was 14.04 and 2.90 per 1,000 peripheral intravenous catheters days, respectively. The adjusted odds ratio of peripheral intravenous extravasation post-intervention compared with that of pre-intervention was 0.20 (95% confidence interval: 0.05–0.74; p = 0.02) after adjusting for peripheral intravenous catheter days. The extravasation from a central line rate of the control and intervention groups post-intervention was 4.94 and zero per 1,000 central venous catheter days, respectively. Fifty-nine registered nurses were recruited. At six months post-program, there were significant improvements in the nurses’ level of knowledge and adherence. Conclusions These findings suggest that the implementation of an evidence-based clinical practice guideline significantly reduced the rate of peripheral intravenous extravasation and extravasation from a central line in neonates. However, to maintain nurses’ knowledge and adherence to the evidence-based practice, the educational program will have to be conducted periodically and incorporated into the nurses’ induction program. Trial registration ClinicalTrials.gov, Identifiers: NCT04321447. Registered 20 March 2020 - Retrospectively registered.
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Affiliation(s)
- Kam Ming Chan
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kowloon, Hong Kong.,The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Genevieve Po Gee Fung
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kowloon, Hong Kong
| | - Wai Wa Lui
- Pharmacy Department, United Christian Hospital, Kowloon, Hong Kong
| | - Meme Suk Ying Chan
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Kowloon, Hong Kong
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
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Qin KR, Ensor N, Barnes R, Englin A, Nataraja RM, Pacilli M. Long peripheral catheters for intravenous access in adults and children: A systematic review of the literature. J Vasc Access 2020; 22:767-777. [PMID: 32529915 DOI: 10.1177/1129729820927272] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Long peripheral catheters are peripheral intravenous catheters of 6-15 cm in length. They are commonly inserted into the forearm, antecubital fossa or upper arm using a direct Seldinger technique. They have proven to be valuable for peripheral intravenous catheters, particularly in patients with difficult intravenous access. METHODS We conducted a systematic review of studies reporting the use of long peripheral catheters. The following keywords were used: 'long', 'Seldinger', 'guidewire', 'peripheral', 'venous', 'intravenous', 'IV', 'vascular', 'cannula' and 'catheter'. RESULTS Three hundred forty-one publications were identified; 16 were included in the systematic review. There were 11 adult studies and 5 paediatric studies documenting 1288 long peripheral catheters in 1271 patients. Majority of studies (12/16) were conducted in acute care settings, (emergency department, n = 6; intensive care unit, n = 3; high dependency unit, n = 1; surgical unit, n = 2). The most frequently studied long peripheral catheter was 8 cm in length and 20 G in size. Nine studies recruited patients with difficult intravenous access; 11 studies used ultrasound guidance. Insertion success rate and mean procedural time ranged between 86% and 100% and 8 and 16.8 minutes, respectively. Average catheter duration ranged between 4 and 14.7 days (mean) and 1.1 and 9 days (median). Catheter failure occurred in 4.3-52.5% of long peripheral catheters, with leakage, infiltration and dislodgement being the most frequent causes of failure. In 3 randomised controlled trials, long peripheral catheters outperformed peripheral intravenous catheters in terms of duration and failure rate. CONCLUSION Long peripheral catheters are safe and reliable in both adults and children. In addition, long peripheral catheters may provide improved quality of care over peripheral intravenous catheters for multi-day intravenous therapy.
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Affiliation(s)
- Kirby R Qin
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Nicholas Ensor
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Richard Barnes
- Department of Anaesthesia, Monash Children's Hospital, Melbourne, VIC, Australia
| | - Anna Englin
- Department of Anaesthesia, Monash Children's Hospital, Melbourne, VIC, Australia
| | - Ramesh M Nataraja
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Department of Surgery, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Maurizio Pacilli
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Department of Surgery, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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13
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Kleidon TM, Rickard CM, Gibson V, Mihala G, Schults JA, Xu H(G, Bauer MJ, Marsh N, Larsen EN, Cattanach P, Ullman AJ. Smile - Secure my intravenous line effectively: A pilot randomised controlled trial of peripheral intravenous catheter securement in paediatrics. J Tissue Viability 2020; 29:82-90. [DOI: 10.1016/j.jtv.2020.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/06/2020] [Accepted: 03/22/2020] [Indexed: 01/07/2023]
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14
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Incidence of peripheral intravenous catheter failure and complications in paediatric patients: Systematic review and meta analysis. Int J Nurs Stud 2020; 102:103488. [DOI: 10.1016/j.ijnurstu.2019.103488] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/28/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022]
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