[Complications due to peripheral venous catheterization. Prospective study].
OBJECTIVE
Peripheral venous catheter (PVC)-associated complications were prospectively evaluated in a 2 month-study performed in 3 different wards.


METHODS
For each inserted PVC, the following complications were observed daily by an external investigator: tenderness, erythema, swelling or induration, palpable cord and purulence. PVC that were removed were systematically sent to the Microbiology department and analysed according to the semi-quantitative method described by Brun-Buisson et al.


RESULTS
A total of 525 PVC (corresponding to 1,036 catheterisation-days) were included. Main clinical complications were erythema (22.1%), tenderness (21.9%), swelling or induration (20.9%), palpable cord (2.7%) and purulence (0.2%). Phlebitis, defined by 2 or more of the following signs: tenderness, erythema, swelling or induration and palpable cord, was observed in 22%. Catheter colonization (> or = 103 CFU/ml) occurred in 13%. Bacteria isolated from colonized catheters were coagulase-negative staphylococci (88.1%), Staphylococcus aureus (7.1%) and Candida sp. (4.8%). Multivariate risk factor analysis showed that age > or = 55 y. (OR = 3.16, p = 0.003), insertion on articulation site (OR = 2.94, p = 0.01) or in jugular vein (OR = 8.18, p = 0.01) and > 72 hour-catheterisation (OR = 4.74, p = 0.0003) were significantly associated with PVC colonization. Risk factors for phlebitis were skin lesions (OR = 1.88, p < 0.016), active infection unrelated to PVC (OR = 2.8, p = 0.001), "poor quality" peripheral vein (OR = 2.46, p < 0.02) and > 72 hour-catherisation (OR = 2.38, p = 0.009).


CONCLUSIONS
Complications associated with peripheral venous catheters are frequent but remain benign. They could probably be reduced by a systematic change every 72-96 hours as recommended by different guidelines.
Barbut
F
F
Unité d'hygiène et de lutte contre les infections nosocomiales (UHLIN) Hôpital Saint-Antoine 184, rue du faubourg Saint-Antoine 75012 Paris. frederic.barbut@sat.ap-hop-paris.fr
Pistone
T
T
Guiguet
M
M
Gaspard
R
R
Rocher
M
M
Dousset
C
C
Meynard
J L
JL
Carbonell
N
N
Maury
E
E
Offenstadt
G
G
Poupon
R
R
Frottier
J
J
Valleron
A J
AJ
Petit
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002177:Candidiasis / Q000209:etiology* / Q000517:prevention & control; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006306:Health Surveys; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010689:Phlebitis / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000209:etiology* / Q000517:prevention & control; D014946:Wound Infection / Q000209:etiology* / Q000517:prevention & control