Incidence and risk factors for peripheral intravenous catheter failure in Japanese neonatal intensive care units and growing care units: a multicenter observational study.

OBJECTIVES

Peripheral intravenous catheters (PIVCs) are used in neonatal intensive care units (NICUs) and growing care units (GCUs). However, neonates/infants in these units frequently experience catheter failure (CF) because of complications, such as extravasation and phlebitis. Nonetheless, data on PIVCs from Japan remain limited. Therefore, this study aimed to investigate the use of infusion catheters and the incidence, characteristics, and risk factors of PIVC-related catheter failure in Japanese NICUs and GCUs.

METHODS

This study was conducted between August 2024 and February 2025 using cross-sectional and prospective surveys. Data from 600 hospitalized neonates/infants and 259 PIVC cases were analyzed. CF was defined as unplanned catheter removal before the completion of therapy owing to loss of function or an inability to administer fluids.

RESULTS

Overall, 48.0% of neonates/infants had infusion catheters. The incidence proportion of CF was 47.1%, with an incidence density of 173.1/1,000 catheter-days. Extravasation was the most frequently identified cause of CF (95.9%), and swelling and leaking were primary symptoms. Multivariate Cox regression showed that gestational age (hazard ratio=0.96, p=.03) and infusion flow volume at the time of PIVC removal (hazard ratio=1.28/1 mL/h, p<.01) were significant risk factors. Long PIVCs had significantly longer dwell times than PIVCs (log-rank p=.01).

CONCLUSIONS

CF is highly prevalent in Japanese infants in NICUs/GCUs, with a rate similar to that reported internationally. Long PIVCs may help extend the catheter dwell times. These findings highlight the need for standardized prevention strategies and improved catheter management protocols.