Safety of peripheral intravenous catheters in children.
OBJECTIVE
To determine the overall and per-day risk of complications of short peripheral intravenous (PIV) catheters placed for indefinite periods.


METHODS
During 5 months, general pediatric patients receiving intravenous therapy through short PIV catheters were monitored. Patient and catheter characteristics were recorded, complications were noted, and rolled semiquantitative cultures of removed catheters were performed. Major endpoints were infection and phlebitis. Per-day risk of complications and catheter colonization (>15 colony-forming units) were calculated.


METHODS
University children's hospital.


METHODS
General pediatric ward inpatients with PIV.


RESULTS
We studied 642 Teflon catheters in place >24 hours (mean, 3.7 days) in 525 patients. There were no cases of catheter sepsis (0%; 95% confidence interval [CI95], 0%-0.6%), one possible insertion-site infection (0.2%; CI95, 0.004%-0.9%), and seven cases of phlebitis (1.1%; CI95, 0.4%-2.3%). Catheter colonization occurred in 92 (26%) of 348 catheters cultured. Neither the per-day risk of phlebitis nor of catheter colonization increased significantly with placement >3 days.


CONCLUSIONS
Current guidelines recommend replacement of PIV catheters in adults within 2 to 3 days; no recommendations are made for children. Our findings and those of others indicate that the overall risk of PIV catheter complications in children is extremely low and would not be reduced substantially by routine catheter replacement.
Shimandle
R B
RB
Infection Control Program, University of Chicago Hospital, Illinois 60637-1470, USA.
Johnson
D
D
Baker
M
M
Stotland
N
N
Karrison
T
T
Arnow
P M
PM
D001419:Bacteria / Q000302:isolation & purification; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010689:Phlebitis / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors