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  • Systematic Review
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Detection of peripheral infusion-related infiltration and extravasation in neonates: a scoping review

Pediatric Research (2025)Cite this article

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2879 records were identified, after 820 duplicates and one retracted article were removed, 2058 were left for initial screening.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.

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Data availability

All relevant data are included in this manuscript and its supplementary information files.

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Acknowledgements

The authors thank Marloes IJff, Information Specialist Research, Information & Library Services, Research Support & Quick Solutions, Medische Bibliotheek, for their support and advice during the conduct of this scoping review.

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Radboud University Medical Center, Amalia Children’s Hospital, Nijmegen, The Netherlands

    Matheus F. P. T. van Rens, Robin van der Lee & Willem P. de Boode

  2. Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands

    Anita Huis

  3. Formerly of Nursing and Midwifery Education, Hamad Medical Corporation, Doha, Qatar

    Kevin Hugill

  4. Independent, Cumbria, UK

    Kevin Hugill

Authors
  1. Matheus F. P. T. van Rens
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  2. Anita Huis
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  4. Robin van der Lee
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  5. Willem P. de Boode
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Contributions

M.v.R. was responsible for the literature search and drafting the manuscript. M.v.R. and A.H. conducted the screening process and review of all retrieved articles. K.H. conducted the primary review of included studies, providing critical analysis and interpretation of the literature. R.v.d.L. and W.P.d.B. critically appraised the manuscript and the overall research process. All authors contributed to manuscript revision and approved the final version for submission. M.v.R. was responsible for drafting the manuscript.

Corresponding author

Correspondence to Matheus F. P. T. van Rens.

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van Rens, M.F.P.T., Huis, A., Hugill, K. et al. Detection of peripheral infusion-related infiltration and extravasation in neonates: a scoping review. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04367-5

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