Center for Advanced Practice

Title

Longevity and Complication Rates of Ultrasound Guided Versus Traditional Peripheral Intravenous Catheters in a Pediatric Emergency Department.

Publication Title

Journal of the Association for Vascular Access

Document Type

Article

Abstract

Background Ultrasound-guided peripheral intravenous lines are frequently used in patients with difficult access. We have previously reported on the longevity and complication rates of ultrasound-guided peripheral intravenous lines, but there are limited data comparing outcomes of ultrasound-guided peripheral intravenous lines to traditionally placed peripheral intravenous lines in children. The aim of this study was to compare the longevity and complication rates of ultrasound-guided peripheral intravenous lines to traditionally placed intravenous lines in a pediatric population. Methods This study analyzed 300 ultrasound-guided peripheral intravenous lines and 552 traditionally placed intravenous lines using patient records to determine the reason and timing for intravenous line removal. A t -test was used to compare overall mean survival times, and a log-rank test was used to compare Kaplan-Meier survival curves. Complication rates were compared using a chi-squared test. Results The survival times of ultrasound-guided peripheral intravenous lines (mean = 73 hours, SD = 68 hours) were significantly longer than those of traditionally placed intravenous lines (mean = 38 hours, SD = 29.4 hours), t (559)  = 8.51, P  < .0001. Kaplan-Meier survival analysis yielded a median ultrasound-guided peripheral intravenous line survival time of 143 hours (IQR = 68-246) and a median traditionally placed intravenous line survival time of 100 hours (IQR = 65-106) with a significant difference between the 2 survival curves by the log-rank test. There was also no significant difference in complication rates between ultrasound-guided peripheral intravenous lines (34.8%) compared to traditionally placed intravenous lines (31.8%), x 2 (1, N  = 517)  = 0.465, P  = .50. Conclusions Our data suggests that ultrasound-guided peripheral intravenous lines are a viable option for children, including those with a history of difficult access. Survival times were longer for ultrasound-guided peripheral intravenous lines versus traditionally placed intravenous lines, and complication rates of the ultrasound-guided peripheral intravenous lines and traditionally placed intravenous lines were similar.

Keywords

Catheterization, Peripheral -- Adverse Effects, Catheterization, Peripheral -- Methods, Chi Square Test, Electronic Health Records, Emergency Service, Human, Log-Rank Test, Pediatric Care, T-Tests, Treatment Outcomes, Ultrasonography -- Utilization

DOI

10.1016/j.java.2018.06.002

Publication Date

9-2018

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