title: Three-phase study of phlebitis in patients receiving peripheral intravenous hyperalimentation.
abstract: We found clinical phlebitis in 57 of 88 patients with peripheral hyperalimentation (65%). To determine if this was a problem common to all intravenous fluid therapy at our hospital, we performed a point-prevalence study. The prevalence of phlebitis in nonhyperalimentation intravenous patients was 18% (84 of 456 patients). We then performed a randomized, prospective, double-blind trial of sham versus standard in-line filters to determine if bacteria or filterable particulate matter was responsible for phlebitis in the peripheral hyperalimentation group. The standard-filter group had a phlebitis rate of 74% compared with 64% in the sham-filter group. We then eliminated in-line filters and replaced the standard glucose-based solution with a glycerol-based peripheral hyperalimentation solution. The phlebitis rate decreased from 68% to 27% (p less than 0.001). In conclusion, phlebitis in peripheral hyperalimentation patients was probably due to chemical properties of the peripheral hyperalimentation solution rather than bacteria or particulates.
authors.affiliation: Nutritional Support Team, Veterans Administration Medical Center, Long Beach, California.
authors.forename: E B
authors.initials: EB
authors.lastname: Rypins
authors.forename: B H
authors.initials: BH
authors.lastname: Johnson
authors.forename: B
authors.initials: B
authors.lastname: Reder
authors.forename: I J
authors.initials: IJ
authors.lastname: Sarfeh
authors.forename: K
authors.initials: K
authors.lastname: Shimoda
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage; D001419:Bacteria / Q000302:isolation & purification; D002408:Catheters, Indwelling / Q000009:adverse effects; D004311:Double-Blind Method; D005374:Filtration / Q000295:instrumentation; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects; D005990:Glycerol / Q000008:administration & dosage; D006801:Humans; D009994:Osmolar Concentration; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D010689:Phlebitis / Q000209:etiology* / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D011897:Random Allocation; D012189:Retrospective Studies
chemical_list: D000596:Amino Acids; D005947:Glucose; D005990:Glycerol