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Intravenous Catheter Complications in the Hand and Forearm

Kagel, Eric M. MD; Rayan, Ghazi M. MD

The Journal of Trauma: Injury, Infection, and Critical Care: January 2004 - Volume 56 - Issue 1 - p 123-127
doi: 10.1097/01.TA.0000058126.72962.74
ORIGINAL ARTICLES
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Background  We studied the complications of peripheral intravenous (IV) catheters in the hand and forearm in a teaching hospital over a 3-year period.

Methods  The records of 67 patients who developed IV catheter-related complications were reviewed.

Results  The most common sites for developing complications in order of frequency were the forearm, hand, wrist, and antecubital fossa. There were 56 minor and 11 major complications. More than 50% of minor complications occurred in the hand and wrist, and more than 50% of major complications occurred in the hand. In 68% of minor complications, the patients were aged 50 years or older and 68% were women. Minor complications comprised 26 intravenous infiltrations, 23 cases of thrombophlebitis, and 7 cases of cellulitis. Ninety percent of major complication patients were aged 50 or older and 82% were women. Major complications included septic thrombophlebitis in three; hematomas resulting in skin necrosis in two; and infiltration related complications in six, resulting in skin necrosis in two, compressive nerve lesions in two, digital stiffness in one, and compartment syndrome in one. Ten patients with major complications were over the age of 50 years and nine were women. Two patients receiving anticoagulation developed large dorsal subcutaneous space hematomas. Chemotherapeutic agents contributed to two minor complications and one major complication.

Conclusion  The hand is a common site for minor and major IV catheter complications. Women and older patients are more susceptible to these complications. Peripheral IV line complications are not uncommon and can result in morbidity and increased health care costs from prolonged hospitalization, extended use of IV antibiotic therapy, and surgical intervention.

From the Orthopedic Surgery Department, University of Oklahoma and Integris Baptist Medical Center, Oklahoma City, Oklahoma.

Submitted for publication August 6, 2002.

Accepted for publication January 6, 2003.

Address for reprints: Ghazi M. Rayan, MD, 3366 N.W. Expressway, Suite 700, Oklahoma City, OK 73112.

© 2004 Lippincott Williams & Wilkins, Inc.