Selected risk factors of vascular access complications in patients treated at an intensive care unit

Introduction
Vascular catheters constitute an indispensable element of the diagnostic-therapeutic procedure in critically ill patients. However, their insertion and maintenance is associated with the risk of occurrence of life-threatening complications.

Aim of the research
To become familiar with selected risk factors of vascular access complications in patients treated at an intensive care unit.

Material and methods
Retrospective studies were carried out at an 11-bed multi-profile Intensive Care Unit in the South of Poland. The studies included using individual and collective medical documentation, the TISS-28 scale, as well as the SOFA and APACHE II classifying scales. The statistical analysis was performed using Statistica 10 PL software. The statistical inference was carried out with a α = 0.05 significance level.

Results and conclusions
Among 1742 inserted vascular accesses, complications occurred in 411 cases. The most frequent cause of decannulation was a suspected infection, an obstruction of the cannula, and the accidental removal of the cannula. The frequency of complications among peripheral venous accesses significantly differed from the mean frequency of complications for all types of intravascular accesses. The number of complications during application of vascular accesses was significantly linearly influenced by the number of accesses, the frequency of manipulations during care activities performed in relation to the cannulas, the number of days a patient stayed in the anaesthesiology and intensive care unit, and in the case of central, dialysis, and arterial catheters also the time of maintaining them. The decompensation of chronic respiratory failure, the duration of the stay at the anaesthesiology and intensive care unit, and the duration of hospitalisation correlated positively with the occurrence of complications, and the mean number of undertaken interventions in the TISS-28 scale correlated negatively.