Does catheter length matter? A comparison of short versus long peripheral intravenous catheters for intravenous antimicrobial delivery in hospitalised adults

Amanda Corley^{1 2 3 5}, Catherine O’Brien^{1 2 3}, Liz Wignall², Asmaa El Heneidy⁴, Hannah Peach², Emily Larsen^{1 2 3}, Claire Rickard^{1 2 3 5 6}, Nicole Marsh^{1 2 3 5} 

¹ School of Nursing and Midwifery, Griffith University, Kessells Rd, Nathan, QLD 4111. amanda.corley@health.qld.gov.au, ² Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, QLD, 4029, ³AVATAR Group, Griffith University, Kessells Rd, Nathan, QLD 4111, ⁴School of Medicine and Dentistry, Griffith University, Kessells Rd, Nathan, QLD 4111, ⁵School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, QLD 4072, ⁶Herston Infectious Diseases Institute, Metro North Health, Butterfield Street, Herston, QLD, 4029

Abstract:

The majority of peripheral intravenous catheters (PIVCs) placed in hospitals are for the delivery of time-critical antimicrobials and a reliable device for antimicrobial delivery is critical to the success of the therapy. Short PIVCs (<4 cm) are the default device for antimicrobial therapy delivery but up to half fail during treatment, resulting in delayed antimicrobial administration, suboptimal drug dosing, patient distress from repeated insertions, and increased healthcare costs. Interruptions to antimicrobial treatment has been linked to re-emergence of infectious disease and antimicrobial resistant organisms.

Longer PIVCs (commonly 4.5-6.4cms) are placed under ultrasound guidance typically into the forearm or upper arm with the catheter tip terminating no higher than the mid-upper arm, and are increasingly used for short-term (1-14 days) peripherally compatible therapy. Long PIVCs allow greater catheter length to reside within the vein, which is strongly linked to device stability and there is some evidence of increased device survival.

This presentation will overview the existing evidence base regarding the use of longer length PIVCs; explore clinical decision making around the use of long PIVCs; and share results of a recent 2-arm randomised controlled trial examining the use of long PIVCs to reduce interruptions to antimicrobial therapy.