Detection of peripheral infusion-related infiltration and extravasation in neonates: a scoping review.

Abstract

Background: Short peripheral catheter (SPC) use is widespread in neonatal care but is associated with serious complications like infiltration and extravasation. Early recognition and prompt management are essential for improving outcomes.

Objective: To examine the evidence on SPC infiltration and extravasation complications in neonates, focusing on incidence, risk factors, detection tools, research gaps, and opportunities for standardization.

Methods: Following the Joanna Briggs Institute (JBI) scoping review framework, we systematically searched five databases (PubMed, EMBASE, CINAHL, Cochrane, and Web of Science) for studies published between January 2000 and May 2024. The search was conducted over a 3-month period (March-May 2024). Studies were included if they focused on SPC-related infiltration or extravasation in neonates in hospital settings. Exclusion criteria included studies on central or arterial lines, non-primary research, or lacking separate neonatal data. Two reviewers independently screened all records using a standardized template.

Results: 2879 records were identified, after 820 duplicates and one retracted article were removed, 2058 were left for initial screening. Of these, 1904 were screened in full, and 30 studies met the inclusion criteria. The reported incidence of infiltration and extravasation ranged widely (up to 70%). Risk factors identified included catheter insertion site, technique, and dwell time, and patient characteristics such as low birth weight. Detection was predominantly by subjective visual and tactile assessment, although emerging technologies such as near-infrared spectroscopy and sensor-based tools were explored in some studies.

Conclusions: SPC-related infiltration and extravasation remain frequent in neonatal care. Despite increasing interest in objective detection tools, their clinical adoption is limited. Standardized definitions and validated early detection methods are essential for improving outcomes and guiding evidence-based practice.

Impact: Addressing a critical neonatal concern-peripheral infiltration/extravasation remains a serious concern in neonatal practice, though its definition and incidence vary widely. This review consolidates existing knowledge, emphasizing the lack of standardized definitions and the need for consensus in clinical assessment. Bridging evidence gaps in prevention-few substantive measures are clinically proven to reduce the incidence and severity of SPC-related complications. This review highlights the limitations of current strategies and the potential of emerging technologies, advocating for robust clinical validation. Guiding future research and practice-the findings call for standardized protocols, multicenter trials, and objective detection tools to improve neonatal vascular access management and patient safety.