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Timing of intravenous administration set changes: a systematic review
Donna Gillies1, Libba O'Riordan, Margaret Wallen
1The Research Development Unit, The School of Nursing, Family and Community Health, The University of Western Sydney, New South Wales, Australia.
Infection Control and Hospital Epidemiology
|April 6, 2004
Summary
Changing intravenous administration sets every 72 hours or more is safe for crystalloid infusions. However, evidence is insufficient to support this interval for parenteral nutrition, especially lipid-containing types, to prevent bloodstream infections (BSI).
Area of Science:
- Infectious Diseases
- Healthcare Management
- Clinical Practice Guidelines
Background:
- Intravenous (IV) administration sets require routine replacement to prevent complications.
- Optimal replacement intervals balance infection risk with resource utilization.
- Current guidelines vary, necessitating evidence-based recommendations.
Purpose of the Study:
- To determine the optimal frequency for replacing IV administration sets.
- To assess the risk of bloodstream infection (BSI) associated with different replacement intervals.
- To differentiate recommendations based on infusate type (crystalloids vs. parenteral nutrition).
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Comprehensive database searches (Cochrane, Medline, CINAHL, CancerLit) and reference checking.
- Analysis of studies comparing IV set change intervals (24h, 48h, 72h, 96h+).
Main Results:
- Good evidence supports changing IV sets every 72 hours or more for crystalloids without increasing infusate-related BSI risk.
- Fair evidence suggests no increased risk of catheter-related BSI with 72-hour or longer intervals.
- Insufficient data exist for parenteral nutrition, particularly lipid-containing formulations.
Conclusions:
- IV administration sets for crystalloid infusions via central or peripheral catheters can be changed every 72 hours or more safely.
- Recommendations for parenteral nutrition, especially lipid emulsions, cannot be made at the 72-hour interval due to insufficient evidence.
- Further research is needed to establish safe replacement intervals for parenteral nutrition administration sets.
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