title: Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital.
abstract: BACKGROUND
  It is generally believed that certain patient characteristics (e.g., Body Mass Index and age) predict difficulty of intravenous cannulation in children, but there is not much literature evaluating these risk factors. In this study, we investigated predictive factors for success rate at first attempt and time needed for intravenous cannulation.
  
  
  METHODS
  In a prospective cohort study, we observed characteristics of intravenous cannulations in pediatric patients at the operating room (n = 1083) and the outpatient care unit (n = 178) of a tertiary referral pediatric hospital. Time to successful intravenous cannulation, success at first attempt, and potential predictors for difficult cannulation (age, gender, skin color, BMI or weight-to-age z-score, the child being awake or anesthetized, operator profession and surgical specialty) were recorded. Regression models were constructed to find significant predictors.
  
  
  RESULTS
  Success at first attempt was 73% and 81%, respectively. In the operating room age, operator and surgical specialty were predictive for a successful first attempt and time to successful cannulation. No significant predictive factors were found for the outpatient care unit. BMI or weight-to-age was not related to difficult intravenous cannulation.
  
  
  CONCLUSIONS
  This study shows that in one-fifth to one-third of the patients, intravenous cannulation required more than one attempt. It is difficult to predict with accuracy the difficulty of intravenous cannulation solely with easily obtainable patient characteristics.
authors.affiliation: Department of Medical Technology & Clinical Physics, University Medical Center, Utrecht, the Netherlands. cuper.thesis@gmail.com
authors.forename: Natascha J
authors.initials: NJ
authors.lastname: Cuper
authors.forename: Jurgen C
authors.initials: JC
authors.lastname: de Graaff
authors.forename: Atty T H
authors.initials: AT
authors.lastname: van Dijk
authors.forename: Rudolf M
authors.initials: RM
authors.lastname: Verdaasdonk
authors.forename: Desirée B M
authors.initials: DB
authors.lastname: van der Werff
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000758:Anesthesia; D000772:Anesthesia, Local; D000776:Anesthesiology; D015992:Body Mass Index; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009719:Nurse Anesthetists; D016017:Odds Ratio; D010045:Outpatients; D011318:Prilocaine; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012880:Skin Pigmentation; D013043:Specialties, Surgical; D016896:Treatment Outcome
chemical_list: D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine