학술논문

Peripheral IV Administration of Hypertonic Saline: Single-Center Retrospective PICU Study*
Document Type
article
Source
Pediatric Critical Care Medicine. 23(4)
Subject
Health Services and Systems
Biomedical and Clinical Sciences
Health Sciences
Pediatric
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Child
Critical Illness
Cross-Sectional Studies
Humans
Intensive Care Units
Pediatric
Retrospective Studies
Saline Solution
Hypertonic
extravasation
hypertonic saline
infiltration
medication complications
pediatric
peripheral intravenous catheter
Nursing
Paediatrics and Reproductive Medicine
Pediatrics
Clinical sciences
Paediatrics
Language
Abstract
ObjectivesTo determine the frequency and characteristics of complications of peripherally administered hypertonic saline (HTS) through assessment of infiltration and extravasation.DesignRetrospective cross-sectional study.SettingFreestanding tertiary care pediatric hospital.PatientsChildren who received HTS through a peripheral IV catheter (PIVC).InterventionsNone.Measurements and main resultsWe conducted a single-center retrospective review from January 2012 to 2019. A total of 526 patients with 1,020 unique administrations of HTS through a PIVC met inclusion criteria. The primary endpoint was PIVC failure due to infiltration or extravasation. The indication for the administration of HTS infusion was collected. Catheter data was captured, including the setting of catheter placement, anatomical location on the patient, gauge size, length of time from catheter insertion to HTS infusion, in situ duration of catheter lifespan, and removal rationale. The administration data for HTS was reviewed and included volume of administration, bolus versus continuous infusion, infusion rate, infusion duration, and vesicant medications administered through the PIVC. There were 843 bolus infusions of HTS and 172 continuous infusions. Of the bolus administrations, there were eight infiltrations (0.9%). The continuous infusion group had 13 infiltrations (7.6%). There were no extravasations in either group, and no patients required medical therapy or intervention by the wound care or plastic surgery teams. There was no significant morbidity attributed to HTS administration in either group.ConclusionsHTS administered through a PIVC infrequently infiltrates in critically ill pediatric patients. The infiltration rate was low when HTS is administered as a bolus but higher when given as a continuous infusion. However, no patient suffered an extravasation injury or long-term morbidity from any infiltration.