Complications of Peripherally Inserted, Large-Bore, Rapid-Infusion Catheters in Orthotopic Liver Transplant Patients

At our institution, peripherally inserted, 8.5-French rapid-infusion catheters (RICs) are placed for high-flow administration of intravenous fluids and blood products during liver transplant (LT). We sought to estimate the incidence of RIC placement–associated complications in LT patients. Electronic health records of all patients who underwent LT from January 2008 through December 2017 were retrospectively reviewed. RIC-related complications were deemed clinically significant if they required surgical consultation or intervention due to infiltration. Univariable and multivariable logistic regression analyses were used to evaluate associations between patient characteristics and RIC complications. In total, 839 LT patients who received RICs were identified; of these, 14 (1.67%) had RIC-related complications, and 7 (0.83%) required surgical consultation. No patients needed fasciotomy or wound débridement due to a RIC complication, and no patients had permanent sequelae. In the multivariable logistic regression analysis, only an increase in international normalized ratio (INR) from 1.4 to 2.2 (equivalent to the interquartile range of observed INR values) increased the odds of complications due to RIC placement (odds ratio [95% CI], 1.98 [1.10-3.56]; P = .02). We observed a low incidence of perioperative RIC-related complications (1.7%). No patients had permanent RIC-related complications. •Rapid-infusion catheter (RIC) complications are uncommon in liver transplantation.•No study patients had permanent sequelae from RIC complications.•Data comparing complications of RICs and other catheters are lacking.