Is Thrombus With Subcutaneous Edema Detected by Ultrasonography Related to Short Peripheral Catheter Failure? A Prospective Observational Study

Abstract

Short peripheral catheter (SPC) failure is an important clinical problem. The purpose of this study was to clarify the relationship between SPC failure and etiologies such as thrombus, subcutaneous edema, and catheter dislodgment using ultrasonography and to explore the risk factors associated with the etiologies. Two hundred catheters that were in use for infusion, excluding chemotherapy, were observed. Risk factors were examined by logistic regression analysis. Sixty catheters were removed as the result of SPC failure. Frequency of thrombus with subcutaneous edema in SPC failure cases was significantly greater than in those cases where therapy was completed without complications (P < .01). Multivariate analysis demonstrated that 2 or more insertion attempts were significantly associated with thrombus with subcutaneous edema. Results suggest that subsurface skin assessment for catheterization could prevent SPC failure.

Exploring the causes of peripheral intravenous catheter failure based on shape of catheters removed from various insertion sites

“…Most plastic catheters are flexible and can bend with the shape of the blood vessel. However, catheters can deform over time (12). Catheters inserted at the antecubital fossa all showed deformation in the middle of the catheter.…”

“…Although the median cubital vein is generally an easy choice because of its large size, catheters at that site may occlude because of kinking resulting from movement of the elbow and/ or a loose attachment. Our previous study revealed that the height-adjusted distance between the puncture point and the antecubital fossa was related to "thrombus with subcutaneous edema related to PIVC failure" (12). Movement in the arm joints (i.e.…”

“…Clarification of these relationships might improve the choice of insertion sites and appropriate catheters to prevent PIVC failure. Therefore, we analyzed information from clinical ultrasound and digital camera images acquired in a previous observational study (12) to investigate the questions. In the previous study, nurses and physicians used short peripheral catheters (SPCs) made of Teflon ® (ethylene tetrafluoroethylene), which is a plastic.…”

“…This study was a secondary analysis of data from our previous study (12). Our observational study was conducted at The University of Tokyo Hospital between January and June 2014.…”

Catheter tips are a possible resource for biological study on catheter failure

“…Intravascular thrombus, subcutaneous edema, and catheter dislodgment have been previously discussed as possible etiologies of peripheral intravenous CF. Our previous study investigated the relationship between the etiology of CF confirmed by ultrasonography and the occurrence of peripheral intravenous CF (15). Notably, no catheter dislodgment was found among the cases of peripheral intravenous CF.…”