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Contamination of intravenous infusion systems--the effect of changing administration sets
Abstract:
Intravenous administration sets were changed at varying time intervals between every 24 h and 120 h in 387 patients. The rates of intraluminal contamination of the cannulae and of local inflammation were measured in relation to the time interval between changing sets. There was no correlation between phlebitis and intraluminal contamination, but a significant association was found between phlebitis and fever, infusion of potassium at greater than 10 mmol l-1, Venflon type 140 and infusion of blood or intralipid. No correlation was found between septicaemia and intraluminal contamination of the infusion systems. Contamination of cannulae increased slightly with time, but this was not statistically significant. We conclude that there will be no clinical benefit by daily changing of administration sets, compared with changing up to every fifth day.
Insights
Daily changing of intravenous administration sets offers no clinical benefit over changing them every five days. This study found no link between contamination and phlebitis or bloodstream infections, suggesting longer intervals are safe.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Practice
Background:
- Intravenous (IV) administration sets require regular changes to prevent complications.
- Current guidelines vary on optimal changing intervals, impacting healthcare costs and resource allocation.
- Understanding the relationship between set duration, contamination, and patient outcomes is crucial.
Purpose of the Study:
- To evaluate the impact of varying intravenous administration set change intervals (24-120 hours) on intraluminal contamination and local inflammation.
- To determine the correlation between set change frequency, intraluminal contamination, and the incidence of phlebitis and septicaemia.
Main Methods:
- Prospective study involving 387 patients undergoing IV therapy.
- Administration sets were changed at intervals ranging from 24 to 120 hours.
- Monitoring for intraluminal cannula contamination, local inflammation (phlebitis), and systemic infection (fever, septicaemia).
Main Results:
- No statistically significant correlation was found between intraluminal contamination and phlebitis or septicaemia.
- Cannula contamination showed a slight, non-significant increase over time.
- Phlebitis was significantly associated with fever, high potassium infusion rates, specific cannula types (Venflon 140), and infusion of blood or intralipid.
Conclusions:
- Daily changing of IV administration sets provides no clinical advantage over changing them up to every five days.
- Current practices of frequent IV set changes may not be necessary and could be optimized.
- Focusing on other risk factors like infusion content and patient condition is more critical for preventing IV-related complications.