Impact of short extension set on peripheral intravenous catheter failure
Abstract:
Background: Peripheral intravenous catheter (PIVC) failure is a significant clinical issue. Evidence is needed on the impact of different PIVC systems on outcomes.
Aim: To analyze the effect of add-on extension sets with integrated connectors on PIVC outcomes in real-world practice.
Methods: A prospective, open-label, quasi-experimental study with blinded analyst was conducted at a tertiary hospital in Barcelona, Spain, comparing two PIVC systems. The control system (standard winged PIVC with add-on needleless connector) was evaluated from March 1 to April 6, 2022, and the study system (with add-on extension set and integrated needleless connector) from September 9 to December 14, 2023. The primary endpoint was overall PIVC failure per 1000 catheter-days, analyzed as relative rate.
Findings: A total of 1019 PIVCs (607 patients) in the control group and 1028 PIVCs (634 patients) in the study group were followed. Groups had similar hospital stay, dwell times, and mortality. Patients in the study group were more likely to have heart disease, COPD, and be physically restrained. Overall, 795 (39.7%) PIVCs failed, a rate of 86.0 per 1000 catheter-days. The most common reasons for unplanned removal were extravasation (10.6%), occlusion (8.1%), accidental removal (7.7%), phlebitis (7.4%), and discomfort (5.5%). PIVC failure was significantly lower in the study group compared with control (37.2% vs. 42.1%, p = 0.025). Failure per 1000 catheter-days showed a non-significant reduction (RR = 0.89; 95% CI 0.77-1.03).
Conclusion: PIVC failure remains high. A PIVC with add-on extension and integrated needleless connector did not show a statistically significant reduction in failure rate.
Reference:
Piriz-Marabajan M, Rombauts A, Roch-Villaverde N, Cortes-Palacios AP, Fernandez-Piqueras E, Serrano-Condal S, Taltavull-Menendez M, Grillo S, Simonetti AF, Duch P, Pomar-Solchaga V, Escolà-Vergé L, Lopez-Contreras J. Impact on peripheral catheter failure with the use of an extension set with integrated needless connector compared to a straight hub: a prospective quasi-experimental study. J Hosp Infect. 2025 Oct 9:S0195-6701(25)00294-4. doi: 10.1016/j.jhin.2025.09.009. Epub ahead of print. PMID: 41075840.