Peripheral Intravenous Cannula Fracture: Increasing Incidence and Management

Christian Emeka Amadi¹ and Justina Omoikhefe Alegbeleye^2,

¹Department of Surgery, University of Port Harcourt, Rivers State, Nigeria.

²Department of Obstetrics and Gynaecology, University of Port Harcourt, Rivers State, Nigeria

Cite this paper

Christian Emeka Amadi and Justina Omoikhefe Alegbeleye. Peripheral Intravenous Cannula Fracture: Increasing Incidence and Management. American Journal of Clinical Medicine Research. 2024; 12(1):13-17. doi: 10.12691/AJCMR-12-1-2

Abstract

Background: Peripheral Intravenous Cannulation is a routine invasive procedure in clinical practice with various associated complications including cannula fracture. Objective: To evaluate the incidence of peripheral intravenous cannula fracture and its management. Materials and Methods: This was a prospective cross-sectional study conducted at the University of Port Harcourt Teaching Hospital between April 1, 2019, and December 31, 2021. A data collection tool designed specifically for the study was used to obtain information on the size of the cannula, cadre of doctor that inserted the cannula, the brand of the cannula, history of reinsertion of the introducer needle during cannulation, duration of the intravenous cannulation, time of presentation and successful retrieval rate. Results: There were 15 cases of broken peripheral IV cannulae. The patients were aged 25-44years, consisting of 1 (6.67%) male and 14 females (93.33%). All the cannulae were 16G (gray) and were inserted mostly preoperatively for caesarean section, 7 (46.67%) of them were inserted by consultants, 4 (26.67%) by Senior Registrars and 4 (26.67%) by Registrars. All the 16G cannulae were made by the same manufacturer. The introducer needle was reinserted in 4 (26.67%) cases. On the average, the cannulae lasted between 3-5days intravenously, 10 (66.67%) of the cases presented within 24hours while 5 (33.33%) presented after 24hoours. Most 12 (80%) of the fractured cannulae segments were successfully retrieved while 3 (20%) had migrated. These peripheral cannula fractures were more prevalent in the first year of the study, where 12 cases were reported. The hospital management was notified of the increase in the rate of peripheral cannula fracture and the use of the brand of peripheral cannula was discontinued. Conclusion: Though technical error during insertion is an issue, the quality of the cannula in these cases appeared to contribute to the increased rate of cannula fracture. Hence, timely presentation is key to successful retrieval.

Keywords

Cannula, Intravenous, Peripheral, Fracture, Retrieval, Port Harcourt

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Isiguzo C, Opara C, Uzoho A, Opara K. Management of accidental fracture and embolization of intravenous cannula in peripheral veins using a novel J‑flap technique: A case series. Niger J Clin Pract 2023; 26: 832-836.
[2]	Rivera AM, Strauss KW, Van Zundert A, Mortier E. The History of Peripheral Intravenous Catheters: How Little Plastic Tubes Revolutionized Medicine. Acta Anaesth Bel 2005; 12271-12278.
[3]	Adeosun PO, Abdulazeez AT, Okeke UI, Ehinmosan OE, Eze EG. CT-guided retrieval of a fractured intravenous cannula in a toddler: A case report. Afr J Emerg Med 2020;10 (4): 277-280.
[4]	Masood A, Malik M, Khan M. A Foreign Body in the Cephalic Vein: Broken Piece of Intravenous Cannula. Cureus 2021;13 (10): e18813.
[5]	Ezeah I, Nweke CM, Adejumo AO, Junaid AO, Ige OO. Seek and You Shall Find- Retrieval of a Retained Fractured Intravenous Cannula by Z-Plasty Incision: A Case Report. Annals Afri Surg 2023; 20 (1): 37-41.
[6]	Nyamuryekung'e MK, Mmari EE, Patel MR. A missing piece: Fracture of peripheral intravenous cannula, a case report. Int J Surg Case Rep 2021; 78: 296-299.
[7]	Khadim MF, Leonard D, Moorehead RA, Hill C. Back to basics: iatrogenic intravenous cannula embolus. Ann R Coll Surg Engl 2013; 95 (7): 110-111.
[8]	Freiberg DB, Barnes DJ. Fatal sepsis following peripheral intravenous cannula embolus. Chest 1992;101 (3): 865-866.
[9]	Bloom A, Woolf Y, Cuenca A. Accidental embolization of an intravenous cannula in the upper limb: retrieval following computed tomography localization, Eur J Emerg Med 1996; 3 (2): 106-107.
[10]	Song M, Wei M, Song Z, Li L, Fan J, Liu M. A foreign body in the cephalic vein: A case report. Medicine (Baltimore). 2018; 97(25): e11144.
[11]	Kumar RR, Ranjan P. Case report: iatrogenic fracture of intravenous cannula during removal with proximal migration. Int J Surg Case Rep 2020; 76: 562-565.
[12]	Singh A, Kaur A, Singh M, Kaur S. CT Guided Removal of Iatrogenic Foreign Body: A Broken Intravenous Cannula. J Clin Diagn Res 2015; 9 (9): 28-29.
[13]	Gunawardena RMTM, Gunawansa N. Intravenous Fracture of a Peripheral Cannula: A Rare Complication of Peripheral Cannulation. J Case Rep 2020; 10: 107-109.
[14]	Khoo PJ, Tay KL, Jamaluddin AA, Gunasaker D. Self-inflicted and iatrogenic peripheral intravenous cannula fracture: A case report. Ann Med Surg (Lond) 2018; 33: 44-46.
[15]	Mishra S, Vijayan PA, Chandan GS, Sarada PP. Fracture of Intravenous Cannula in External Jugular Vein: A Case Report. Int Res Med Health Sci 2020; 3 (3): 1-5.
[16]	Syeda SN, Ketana VRR, Muntimadugu BT, Jaju MR. Management of Fractured Peripheral Venous Cannulae: A Case Report of Two Cases and Review of Literature. SN Compr Clin Med 2021; 3 (3): 1-4.
[17]	Karunathilaka C, Wijesundara V, Madushanka N. Intravenous Fracture of a Peripheral Cannula at the Dorsum of the Hand in a Patient Who Used Walking Aids after Surgery. Open J Orthoped 2021; 11: 146-152.