Peripheral venous catheters (PVC) are widely used in the hospital and seem to be innocent. However, complications can be devastating. We present a case of a fatal septic shock due to vertebral osteomyelitis after PVC-...Peripheral venous catheters (PVC) are widely used in the hospital and seem to be innocent. However, complications can be devastating. We present a case of a fatal septic shock due to vertebral osteomyelitis after PVC-related Staphylococcus aureus bacteremia (SAB). Staphylococcus aureus is a leading cause of bacteraemia in both the community and the hospital with a significantly increased incidence over the last several decades. Intravascular catheters are the most common cause of SAB. Morbidity and mortality are high, even with appropriate therapy. Although complications are known and common, they may be difficult to recognize. Vertebral osteomyelitis is one of these known severe complications.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Peripheral venous ca...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Peripheral venous catheters (PVCs) are the most commonly used medical devices in hospitals for the administration of medications. Their use can lead to complications of varying severity. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> Determine the incidence and factors associated with the occurrence of PVC-related complications. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a two-month prospective observational study conducted in the Medical Emergency Department (MED) of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. All patients admitted during the study period who had a PVC inserted and removed were included in the study. Logistic regression analysis was used to identify the factors associated with the occurrence of complications. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In total, 459 PVCs were inserted and removed in 415 patients hospitalized at the Medical Emergency Department during the study period. The placement of 37.7% (n = 173) of PVCs resulted in complications in 131 patients (31.6%). For 644.3 days of catheterization, the incidence density was estimated at 6.5 complications per 1000 patient days. Phlebitis (24.0%), infection (5.7%), and accidental removal (2.8%) were the most frequently identified complications. The average age of the patients was 46.8 ± 18.9 years with a sex ratio of 1.22. The average patient hospitalization duration was 2.5 ± 2.6 days. In multivariate analysis, the factors significantly associated with the occurrence of complications after PVC insertion were patient’s state of agitation during the procedure (aOR = 12.59;95% CI = 4.12 - 38.49), placement of the PVC at the elbow bend (aOR = 2.17;95% CI = 1.86 - 5.52), multiple attempts (aOR = 3.18;95% CI = 1.49 - 6.75), administration of 10% hypertonic glucose solution (aOR = 3.67;95% CI = 1.62 - 8.33), and duration of catheterization beyond 72 hours without being changed (aOR = 33.00;95% CI = 14.19 - 76.75). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The incidence of PVC-related complications was relatively high. The identification of the factors that can lead to these complications is relevant to the delivery of quality healthcare to patients.展开更多
文摘Peripheral venous catheters (PVC) are widely used in the hospital and seem to be innocent. However, complications can be devastating. We present a case of a fatal septic shock due to vertebral osteomyelitis after PVC-related Staphylococcus aureus bacteremia (SAB). Staphylococcus aureus is a leading cause of bacteraemia in both the community and the hospital with a significantly increased incidence over the last several decades. Intravascular catheters are the most common cause of SAB. Morbidity and mortality are high, even with appropriate therapy. Although complications are known and common, they may be difficult to recognize. Vertebral osteomyelitis is one of these known severe complications.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Peripheral venous catheters (PVCs) are the most commonly used medical devices in hospitals for the administration of medications. Their use can lead to complications of varying severity. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> Determine the incidence and factors associated with the occurrence of PVC-related complications. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a two-month prospective observational study conducted in the Medical Emergency Department (MED) of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. All patients admitted during the study period who had a PVC inserted and removed were included in the study. Logistic regression analysis was used to identify the factors associated with the occurrence of complications. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In total, 459 PVCs were inserted and removed in 415 patients hospitalized at the Medical Emergency Department during the study period. The placement of 37.7% (n = 173) of PVCs resulted in complications in 131 patients (31.6%). For 644.3 days of catheterization, the incidence density was estimated at 6.5 complications per 1000 patient days. Phlebitis (24.0%), infection (5.7%), and accidental removal (2.8%) were the most frequently identified complications. The average age of the patients was 46.8 ± 18.9 years with a sex ratio of 1.22. The average patient hospitalization duration was 2.5 ± 2.6 days. In multivariate analysis, the factors significantly associated with the occurrence of complications after PVC insertion were patient’s state of agitation during the procedure (aOR = 12.59;95% CI = 4.12 - 38.49), placement of the PVC at the elbow bend (aOR = 2.17;95% CI = 1.86 - 5.52), multiple attempts (aOR = 3.18;95% CI = 1.49 - 6.75), administration of 10% hypertonic glucose solution (aOR = 3.67;95% CI = 1.62 - 8.33), and duration of catheterization beyond 72 hours without being changed (aOR = 33.00;95% CI = 14.19 - 76.75). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The incidence of PVC-related complications was relatively high. The identification of the factors that can lead to these complications is relevant to the delivery of quality healthcare to patients.