title: Closed intravenous administration of gonadotropin-releasing hormone: safety of extended peripheral intravenous catheterization.
abstract: The use of pulsatile gonadotropin-releasing hormone is an effective means of inducing ovulation, but requires prolonged intravenous (IV) or subcutaneous administration. We hypothesized that the use of self-contained infusion pumps using fluids maintained in a closed system would permit safe peripheral IV administration of gonadotropin-releasing hormone, and possibly other hormones, over prolonged intervals. Thirty-eight female patients undergoing pulsatile IV gonadotropin-releasing hormone therapy were followed for 1958 catheter days (230 catheters). Catheters were removed for signs of local inflammation, at the completion of a treatment episode or, initially, at routine intervals of 7-10 days. There were no episodes of fever (temperature over 37.5C) and three episodes of local inflammation. The incidence of significant catheter-tip cultures was 11%, and none were associated with local inflammation. There were four positive blood cultures (2%), none associated with local or systemic signs of infection. We conclude that the use of a closed system of prolonged peripheral IV cannulation is relatively safe when combined with fastidious care of the catheter site and careful outpatient monitoring for long-term administration of pulsatile gonadotropin-releasing hormone.
authors.affiliation: Infection Control Unit, Massachusetts General Hospital, Boston.
authors.forename: C C
authors.initials: CC
authors.lastname: Hopkins
authors.forename: J E
authors.initials: JE
authors.lastname: Hall
authors.forename: N F
authors.initials: NF
authors.lastname: Santoro
authors.forename: K A
authors.initials: KA
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Filicori
authors.forename: W F
authors.initials: WF
authors.lastname: Crowley
mesh_terms: D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D004866:Equipment Contamination; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects; D007262:Infusions, Intravenous / Q000009:adverse effects; D010062:Ovulation Induction / Q000379:methods*; D010906:Pituitary Hormone-Releasing Hormones / Q000008:administration & dosage*
chemical_list: D010906:Pituitary Hormone-Releasing Hormones