Peripheral catheterization

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In medicine, peripheral catheterization is "insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes"[1] such as intravenous infusion of medications or fluid therapy. This is in contrast to central venous catheterization.

Complications

Several complications can occur.[2]

Infiltration

The most common complication is infiltration of the intravenous infusion into the tissue surrounding the vein. This happens to approximately a third of catheterizations within 3 days.[3] This may be difficult to distinguish from phlebitis.[4]

Bacterial colonization

The rate of bacterial colonization is depending on duration of catheterization is:[3]

  • 4 days is 1.0%
  • 5–9 days is 1.9%
  • 10–14 days 3.5%
  • 15–19 days is 7.0%
  • 20–24 days is 6.0%
  • >24 days is 5.7%

Phlebitis

Phlebitis occurs in approximately 3% of catheterizations within 3 days.[3] This may be difficult to distinguish from phlebitis.[4] Phlebitis has been defined as "two or more of pain, tenderness, warmth, erythema, swelling, or a palpable cord."[3]

Prevention of complications

Routine replacement of peripheral catheterization every three days has similar complications to only replacing when complications occur.[5]

References

  1. Anonymous (2024), Peripheral catheterization (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Bregenzer T, Conen D, Sakmann P, Widmer AF (January 1998). "Is routine replacement of peripheral intravenous catheters necessary?". Arch. Intern. Med. 158 (2): 151–6. PMID 9448553[e]
  3. 3.0 3.1 3.2 3.3 Khalifa R, Dahyot-Fizelier C, Laksiri L, et al (October 2008). "Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients". Intensive Care Med 34 (10): 1820–6. DOI:10.1007/s00134-008-1139-z. PMID 18483721. Research Blogging.
  4. 4.0 4.1 Wright A, Hecker J (August 1991). "Infusion failure caused by phlebitis and extravasation". Clin Pharm 10 (8): 630–4. PMID 1934920[e]
  5. Webster J, Clarke S, Paterson D, et al (2008). "Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial". BMJ 337: a339. PMID 18614482. PMC 2483870[e]