Ultrasonography-Observed Subcutaneous Edema Immediately After Peripheral Intravenous Catheter Placement Is a Factor in Subsequent Catheter Failure

Objective: This study aimed to examine the effects of subcutaneous tissue edema at the site of peripheral intravenous catheters (PIVCs) on catheter failure. Methods: A secondary analysis was conducted based on an interventional study performed in 1 ward of the University of Tokyo Hospital. Participants included patients with PIVCs without ultrasonographic-guided insertion. Ultrasonographic images were obtained immediately after catheter placement was completed to assess for success of catheterization and subcutaneous edema. Catheter failure was defined as a PIVC with incomplete treatment. Other measured variables included nursing skill defined as number of experiences of catheterization, medications, medical history, anatomical site of catheterization, diameter of vein, and depth of the catheterization. Results: Of the 273 PIVC cases analyzed, 19 (7.0%) had subcutaneous edema immediately after catheter placement, and 79 (28.9%) resulted in catheter failure, 15 (78.9%) of which occurred among patients with subcutaneous edema (P <.01). Subcutaneous edema immediately after catheter placement was significantly associated with catheter failure occurrence (P <.01), with an adjusted hazard ratio of 9.4 (95% confidence interval 4.62-19.44). Conclusion: Subcutaneous edema was identified as a predictor of catheter failure. Ultrasonographic observation of subcutaneous edema at PIVC placement may be effective in preventing catheter failure occurrence.