Document Type : Original Article
- Habib Yaribeygi 1
- Mohammad Javad Hosseini 2
- Hamid Rokhsarizadeh 3
- Gholam Hossein Meftahi 1
- Mahmoud Salesi 4
1 Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
2 Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
3 Baqiyatallah University of Medical Sciences, Tehran, IR Iran
4 Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Background: Intravenous catheterization is a routine technique in medical centers which can cause diverse problems such as thrombophlebitis.
Objective: This study aimed to resolve replacement scheduling and proper cannula diameter and position issues for intravenous catheters.
Methods: In this 2015 experimental cohort study, 232 hospitalized patients receiving medication intravenously were assessed for the occurrence of thrombophlebitis (TF). Involved TF factors such as age, gender, cannula size, site of cannula in hand veins, duration of usage, and underlying disease were evaluated in patient and healthy control groups.
Results: TF developed in 55 of 232 patients. The percentages of incidence were similar in men and women (30%). The patient mean age was lower than that of the control, but the difference was not significant. Average weight was significantly higher in the patient group than in the control group. The average duration of cannula in situ was significantly lower in patients than in the control group. The highest rate of TF occurred in the narrowest cannula usage and dorsal hand vein positions. The mean time of developing TF was lower than that indicated in CDC guidelines. Furthermore, 24 patients with TF (34%) had diabetes mellitus.
Conclusion: In the current study, the percentage of TF occurrence was higher in patients with weight increase, use of narrower cannulae, dorsal hand vein positions, and a history of diabetes. Furthermore, TF can develop within 72 hours. It was concluded that some patients may be more susceptible to TF and require more care. Accordingly, the CDC guidelines’ offered scheduling for intravenous catheter replacement is not trustworthy.
- Zingg W, Imhof A, Maggiorini M, Stocker R, Keller E, Ruef C. Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheter-related bloodstream infections. Crit Care Med. 2009;37(7):2167-73. [DOI]
- Dychter SS, Gold DA, Carson D, Haller M. Intravenous therapy: a review of complications and economic considerations of peripheral access. J Infus Nurs. 2012;35(2):84-91. [DOI]
- Di Nisio M, Peinemann F, Porreca E, Rutjes AW. Treatment for superficial infusion thrombophlebitis of the upper extremity. Cochrane Database Syst Rev. 2015;11:CD011015. [DOI]
- Curran E, Coia J, Gilmour H, McNamee S, Hood J. Multi-centre research surveillance project to reduce infections/phlebitis associated with peripheral vascular catheters. J Hosp Infect. 2000;46(3):194-202. [DOI]
- Lundgren A, Wahren LK, Ek A-C. Peripheral intravenous lines: time in situ related to complications. J Infus Nurs. 1996;19(5):229-38.
- Grüne F, Schrappe M, Basten J, Wenchel H, Tual E, Stützer H. Phlebitis rate and time kinetics of short peripheral intravenous catheters. Infection. 2004;32(1):30-2. [DOI]
- Higginson R PA. Phlebitis: treatment, care and prevention, a review. NursTime. 2011;107(36):4.
- Ray‐Barruel G, Polit DF, Murfield JE, Rickard CM. Infusion phlebitis assessment measures: a systematic review. J Eval Clin Pract. 2014;20(2):191-202. [DOI]
- Tagalakis V, Kahn SR, Libman M, Blostein M. The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med. 2002;113(2):146-51. [DOI]
- Lee W-L, Chen H-L, Tsai T-Y, Lai I-C, Chang W-C, Huang C-H, et al. Risk factors for peripheral intravenous catheter infection in hospitalized patients: a prospective study of 3165 patients. Am J Infect Control. 2009;37(8):683-6. [DOI]
- Jorgensen J, Hanel K, Morgan A, Hunt J. The incidence of deep venous thrombosis in patients with superficial thrombophlebitis of the lower limbs. J Vasc Surg. 1993;18(1):70-3. [DOI]
- Noël-Savina E, Paleiron N, Le Gal G, Descourt R. [Septic pulmonary embolism after removal of a venous access device for septic thrombophlebitis]. J Mal Vasc. 2012;37(3):146-9. [DOI]
- Mouton, Kienle, Muggli, Naef, Wagner. Tumors associated with superficial thrombophlebitis. Vasa. 2009;38(2):167-70. [DOI]
- Diaconu C, Mateescu D, Bălăceanu A, Marcu M, Jianu V, Stănică A. Pancreatic cancer presenting with paraneoplastic thrombophlebitis–case report. J Med Life. 2010;3(1):96.
- Cicolini G, Bonghi AP, Di Labio L, Di Mascio R. Position of peripheral venous cannulae and the incidence of thrombophlebitis: an observational study. J Adv Nurs. 2009;65(6):1268-73. [DOI]
- Myrianthefs P, Sifaki M, Samara I, Baltopoulos G. The epidemiology of peripheral vein complications: evaluation of the efficiency of differing methods for the maintenance of catheter patency and thrombophlebitis prevention. J Eval Clin Pract. 2005;11(1):85-9. [DOI]
- Uslusoy E, Mete S. Predisposing factors to phlebitis in patients with peripheral intravenous catheters: a descriptive study. J Am Acad Nurse Pract. 2008;20(4):172-80. [DOI]
- Lundgren A, Jorfeldt L, Ek AC. The care and handling of peripheral intravenous cannulae on 60 surgery and internal medicine patients: an observation study. J Adv Nurs. 1993;18(6):963-71. [DOI]
- O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter–related infections. Clin Infect Dis. 2002;35(11):1281-307. [DOI]
- Myrianthefs P, Karatzas S, Baltopoulos G. Complications, thrombophlebitis rates, and intravenous catheter replacement strategies. Infection. 2005;33(2):96-7. [DOI]
- O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39(4):S1-S34. [DOI]
- Gaukroger P, Roberts J, Manners T. Infusion thrombophlebitis: a prospective comparison of 645 Vialon and Teflon cannulae in anaesthetic and postoperative use. Anaesth Intensive Care. 1988;16(3):265-71.
- Cicolini G, Manzoli L, Simonetti V, Flacco ME, Comparcini D, Capasso L, et al. Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi‐centre prospective study. J Adv Nurs. 2014;70(11):2539-49. [DOI]
- Macklin D. Phlebitis: A painful complication of peripheral IV catheterization that may be prevented. Am J Nurs. 2003;103(2):55-60. [DOI]
- Karadag A, Görgülü S. Effect of two different short peripheral catheter materials on phlebitis development. J Infus Nurs. 2000;23(3):158-66.
- Rickard CM, Webster J, Wallis MC, Marsh N, McGrail MR, French V, et al. Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet. 2012;380(9847):1066-74. [DOI]
- Maki DG. ACP Journal Club. Clinically indicated and routine replacement of peripheral IV catheters did not differ for phlebitis. Ann Intern Med. 2013;158(2):JC8. [DOI]
- Wu MA, Casella F. Is clinically indicated replacement of peripheral catheters as safe as routine replacement in preventing phlebitis and other complications? Intern Emerg Med. 2013;8(5):443-4. [DOI]