Peripheral catheterization
In medicine, peripheral catheterization is "insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes"[1] such as intravenous infusion of medications or fluid therapy. This is in contrast to central venous catheterization.
Equipment and procedure
Intravenous catheterization is most common. An area over a suitable vein is cleaned, and one of two types of catheter insertion devices is used. One uses a large-bore metal needle inside which is a plastic catheter, and the other uses a plastic catheter over a stiffening sharp metal core. Once in the vein, the metal device is removed, the catheter attached to the fluid delivery system, and a sterile adhesive dressing put over the puncture site, both to protect it from infection and to keep the catheter in place.
Complications
Several complications can occur.[2]
Infiltration
The most common complication is infiltration of the intravenous infusion into the tissue surrounding the vein. This happens to approximately a third of catheterizations within 3 days.[3] This may be difficult to distinguish from phlebitis.[4]
Bacterial colonization
The rate of bacterial colonization is depending on duration of catheterization is:[3]
- 4 days is 1.0%
- 5–9 days is 1.9%
- 10–14 days 3.5%
- 15–19 days is 7.0%
- 20–24 days is 6.0%
- >24 days is 5.7%
Phlebitis
Phlebitis occurs in approximately 3% of catheterizations within 3 days.[3] This may be difficult to distinguish from phlebitis.[4] Phlebitis has been defined as "two or more of pain, tenderness, warmth, erythema, swelling, or a palpable cord."[3]
Prevention of complications
Routine replacement of peripheral catheterization every three days has similar complications to only replacing when complications occur.[5]
References
- ↑ Anonymous (2024), Peripheral catheterization (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Bregenzer T, Conen D, Sakmann P, Widmer AF (January 1998). "Is routine replacement of peripheral intravenous catheters necessary?". Arch. Intern. Med. 158 (2): 151–6. PMID 9448553. [e]
- ↑ 3.0 3.1 3.2 3.3 Khalifa R, Dahyot-Fizelier C, Laksiri L, et al (October 2008). "Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients". Intensive Care Med 34 (10): 1820–6. DOI:10.1007/s00134-008-1139-z. PMID 18483721. Research Blogging.
- ↑ 4.0 4.1 Wright A, Hecker J (August 1991). "Infusion failure caused by phlebitis and extravasation". Clin Pharm 10 (8): 630–4. PMID 1934920. [e]
- ↑ Webster J, Clarke S, Paterson D, et al (2008). "Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial". BMJ 337: a339. PMID 18614482. PMC 2483870. [e]