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RISK FACTORS AFFECTING THE SURVIVAL OF PERIPHERAL INTRAVENOUS LINES IN INFANTS

We evaluated prospectively the effect of 11 variables on the survival of PVL. PVL were monitored from the time of cannula placement to discontinuation. Sites were inspected hourly for clinical signs of infiltration. 151 PVL were studied in patients whose median age was 1 month (range 0.1-8.7 months). 58% of PVL infiltrated. The time to infiltration was 36.3 ± 33.5 (mean ± SD) hrs (median:40 hrs;range 10-187 hrs). No difference existed in non-infiltrated vs infiltrated PVL for patient age, sex, weight, cannula type/gauge, site, infusion device, IV drugs, administration rate, or potassium/dextrose solution concentration. Infiltration frequency was > in blacks than whites (p=0.03), and with lower controller head heights (p=0.01). Infiltration probability was significant for, steel > teflon cannulas (p=0.02), IV drug > no drug (p=0.03), and with increasing cannula gauge (p=0.05). No difference in the time to infiltration existed for 5% vs 10% dextrose, potassium ≤ 20 mEq/L vs > 20mEq/L, and gravity controlled vs positive pressure infusion devices. No tissue sloughing or necrosis occurred. Only 13% of infiltrated PVL were associated with an audible infusion device alarm. We conclude: 1) black infants, decreasing controller head height, increasing cannula gauge, use of steel needles, and IV drug administration increases the probability of and decreases the time to infiltration, and 2) present infusion device alarms do not reliably detect infiltration in infants.