Exploring the safe dwell time of peripheral venous catheters in pediatric patients: A prospective cohort study

OBJECTIVES: To explore the safe dwell time of peripheral venous catheters (PVCs) and factors associated with catheter-related complications in pediatric patients. METHODS: A prospective multicenter study was conducted in six tertiary hospitals from April to July 2024. All PVCs were required to be removed based on clinical indication rather than routine time-based replacement. Pediatric patients (aged 3-13 years) receiving peripheral catheterization were included. Multivariable logistic regression and restricted cubic spline models were used to examine nonlinear associations between catheter dwell time and complications. RESULTS: Among 1527 enrolled patients, 1421 (93.1%) underwent clinically indicated catheter removal. Complications occurred in 626 patients (44.0%). The median time to complications onset was 71 h. Restricted cubic spline analysis demonstrated a nonlinear association between dwell time and complications, with an inflection point at approximately 136 h. Risk declined prior to this point and showed a non-significant upward trend thereafter. CONCLUSION: Catheter dwell time alone may not be the risk factors for catheter-related complications in pediatric patients. An inflection point was observed at approximately 136 h, beyond which enhanced monitoring may be warranted. IMPLICATIONS TO PRACTICE: These findings support clinically indicated removal with careful surveillance rather than routine time-based replacement.