QJM Advance Access published online on July 11, 2008
QJM, doi:10.1093/qjmed/hcn078
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Factors that affect longevity of intravenous cannulas: a prospective study
1From the St Vincent's Private Hospital, Elm Park, 2Department of Surgery, St Vincent's University Hospital, 3Department of Statistics, Trinity College and 4Department of Medicine, St Vincent's; University Hospital, Dublin, Ireland
Address correspondence to Mary Dillon, Department of Surgery, Education and Research Centre, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. email: maryfdillon{at}hotmail.com
Received 31 March 2008 and in revised form 9 June 2008
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Abstract |
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Background: Few guidelines exist to guide medical personnel on the most successful means of achieving sustained intravenous cannulation. This study examines the impact of gauge and site of intravenous cannulas (IC) on the longevity of ICs in hospitalized patients.
Methods: A prospective study was conducted on 500 ICs inserted into patients of St Vincent's Private hospital from December 2005 to June 2006. Patients were followed until the IC had been removed or changed. Statistical analysis was performed using Cox proportional hazards.
Results: Of the 500 ICs inserted, 37% were 18 g, 46% were 20 g and 18% were 22 g. Gauge of IC was the most significant predictor of increased longevity of IC (P = 0.0002, RR = 1.17, 95% CI 1.08–1.27). The median survival of 18, 20 and 22 g were 57 h (95% CI 49–72), 43 h (95% CI 36–48.5) and 29 h (95% CI 24–40.5), respectively. The site of IC placement influenced the longevity of ICs (P = 0.005, RR= 0.7, 95% CI 0.55–0.9), as did male gender (P = 0.03, RR = 0.76, 95% CI 0.6–0.97). However in subgroup analysis, the most marked effect on IC longevity was evident in those patients with 18 g placed in the forearm/wrist (median 72 h) with less marked changes in other site/gauge combinations. In contrast, 22 g ICs placed in the hand had a median lifespan of 29 h.
Conclusion: IC gauge and site of placement are important factors in determining IC longevity. 18 g ICs placed in the forearm/wrist can considerably increase the longevity of ICs and should be attempted in patients who require sustained cannulation.