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Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study
Background. Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141318/ https://www.ncbi.nlm.nih.gov/pubmed/32183475 http://dx.doi.org/10.3390/jcm9030799 |
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author | Rodriguez-Calero, Miguel Angel de Pedro-Gomez, Joan Ernest Molero-Ballester, Luis Javier Fernandez-Fernandez, Ismael Matamalas-Massanet, Catalina Moreno-Mejias, Luis Blanco-Mavillard, Ian Moya-Suarez, Ana Belén Personat-Labrador, Celia Morales-Asencio, José Miguel |
author_facet | Rodriguez-Calero, Miguel Angel de Pedro-Gomez, Joan Ernest Molero-Ballester, Luis Javier Fernandez-Fernandez, Ismael Matamalas-Massanet, Catalina Moreno-Mejias, Luis Blanco-Mavillard, Ian Moya-Suarez, Ana Belén Personat-Labrador, Celia Morales-Asencio, José Miguel |
author_sort | Rodriguez-Calero, Miguel Angel |
collection | PubMed |
description | Background. Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The aim of this study is to consider these risk factors, to determine the influence of the hospital setting, to examine the association between DPIVC and the different techniques of catheter insertion and to analyse the importance of the clinician’s experience in this context. Methods. Case-control study following a previously published protocol, conducted in 48 units of eight public hospitals in Spain. Adult patients requiring a peripheral intravenous cannula were prospectively included in the study population during their hospital stay. Over a period of 11 months, for consecutive eligible patients, nurses in each participating unit recorded data on their assessment of the vascular access performed and the technique used. Variables related to these medical personnel were also recorded. One of the researchers reviewed the patients’ clinical history to compile the relevant health variables and to characterise the healthcare process. The statistical analysis included association tests among the main study variables. The risk factors were analysed using bivariate logistic regression. The variables found to be statistically significant were included in a multivariate logistic regression model incorporating each of the healthcare environments identified. Results. The study population was composed of 2662 patients, of whom 221 (8.3%) presented with DPIVC. A previous history of difficulty, the presence of non-palpable veins, acute upper limb alterations and punctures in the ante-cubital fossa were found to be independent risk factors for DPIVC. Differences were found in the frequency of occurrence of DPIVC and in some risk factors, according to the healthcare context. The variables related to the characteristics of the hospital personnel did not influence the study event. Conclusion: The present study identifies four independent risk factors for DPIVC that can be incorporated into algorithms aimed at preventing its occurrence and facilitating the referral of patients to vascular access specialist teams. |
format | Online Article Text |
id | pubmed-7141318 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71413182020-04-10 Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study Rodriguez-Calero, Miguel Angel de Pedro-Gomez, Joan Ernest Molero-Ballester, Luis Javier Fernandez-Fernandez, Ismael Matamalas-Massanet, Catalina Moreno-Mejias, Luis Blanco-Mavillard, Ian Moya-Suarez, Ana Belén Personat-Labrador, Celia Morales-Asencio, José Miguel J Clin Med Article Background. Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The aim of this study is to consider these risk factors, to determine the influence of the hospital setting, to examine the association between DPIVC and the different techniques of catheter insertion and to analyse the importance of the clinician’s experience in this context. Methods. Case-control study following a previously published protocol, conducted in 48 units of eight public hospitals in Spain. Adult patients requiring a peripheral intravenous cannula were prospectively included in the study population during their hospital stay. Over a period of 11 months, for consecutive eligible patients, nurses in each participating unit recorded data on their assessment of the vascular access performed and the technique used. Variables related to these medical personnel were also recorded. One of the researchers reviewed the patients’ clinical history to compile the relevant health variables and to characterise the healthcare process. The statistical analysis included association tests among the main study variables. The risk factors were analysed using bivariate logistic regression. The variables found to be statistically significant were included in a multivariate logistic regression model incorporating each of the healthcare environments identified. Results. The study population was composed of 2662 patients, of whom 221 (8.3%) presented with DPIVC. A previous history of difficulty, the presence of non-palpable veins, acute upper limb alterations and punctures in the ante-cubital fossa were found to be independent risk factors for DPIVC. Differences were found in the frequency of occurrence of DPIVC and in some risk factors, according to the healthcare context. The variables related to the characteristics of the hospital personnel did not influence the study event. Conclusion: The present study identifies four independent risk factors for DPIVC that can be incorporated into algorithms aimed at preventing its occurrence and facilitating the referral of patients to vascular access specialist teams. MDPI 2020-03-15 /pmc/articles/PMC7141318/ /pubmed/32183475 http://dx.doi.org/10.3390/jcm9030799 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rodriguez-Calero, Miguel Angel de Pedro-Gomez, Joan Ernest Molero-Ballester, Luis Javier Fernandez-Fernandez, Ismael Matamalas-Massanet, Catalina Moreno-Mejias, Luis Blanco-Mavillard, Ian Moya-Suarez, Ana Belén Personat-Labrador, Celia Morales-Asencio, José Miguel Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title | Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title_full | Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title_fullStr | Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title_full_unstemmed | Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title_short | Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study |
title_sort | risk factors for difficult peripheral intravenous cannulation. the pivv2 multicentre case-control study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141318/ https://www.ncbi.nlm.nih.gov/pubmed/32183475 http://dx.doi.org/10.3390/jcm9030799 |
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