Julienne Grace Bautista

Philippine General Hospital,
Philippine

Abstract Title: Incidence of Extravasation Injury among Critically Ill Pediatric Patients Receiving Vasoactive Infusion through Peripheral Intravenous Access in a Tertiary Hospital in the Philippines - A Prospective Observational Study

Biography:

Dr. Julienne Grace E. Bautista has completed her MD at the age of 21 years from University of the Philippines, Manila, and is graduating this December 2025 from her Residency in Pediatrics in Philippine General Hospital.

Research Interest:

Incidence of Extravasation Injury among Critically Ill Pediatric Patients Receiving Vasoactive Infusion through Peripheral Intravenous Access in a Tertiary Hospital in the Philippines - A Prospective Observational Study

Background:
Peripheral vasoactive infusions are commonly used in critically ill children especially when central access is limited. Extravasation is a recognized complication for this route of delivery, but prospective data from low- and middle-income countries is scarce.

Objective:
To determine the incidence, predictors, and outcomes of extravasation among children receiving peripheral vasoactive medications in a tertiary hospital in the Philippines

Methods:
In this prospective observational cohort, patients aged 1 month to 18 years receiving peripheral vasoactive infusions were monitored for extravasation. Incidence was reported per patient and per line exposure. Risk factors were analyzed using multivariate logistic regression, and a predictive model was developed.

Results:
Of the 48 patients, 28 experienced at least one extravasation event (58%; 14 events per 1000 IV-line hours). Independent predictors were lower extremity placement (OR 95.7; 95% CI, 4.3–2151.7) and number of peripheral accesses (OR 19.3; 95% CI, 1.7–212.1), with the predictive model showing excellent discrimination (AUC = 0.94, sensitivity 92.9%, specificity 85.0%). Median time to extravasation was 21 hours but most injuries (83%) were mild and self-limiting. Overall mortality was 52%, primarily due to underlying illness rather than as extravasation complication.

Conclusion: 
Extravasation is common but usually mild in children receiving peripheral vasoactive infusions. While lower extremity placement has been a previously recognized risk factor, the number of peripheral accesses emerged as a novel predictor, reflecting cumulative vascular burden. Site selection, minimizing and monitoring accesses, and timely escalation to central lines can enhance safety, supporting peripheral infusion as a feasible short-term strategy.