Closed intravenous administration of gonadotropin-releasing hormone: safety of extended peripheral intravenous catheterization.
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.
Hopkins
C C
CC
Infection Control Unit, Massachusetts General Hospital, Boston.
Hall
J E
JE
Santoro
N F
NF
Martin
K A
KA
Filicori
M
M
Crowley
W F
WF
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*
D010906:Pituitary Hormone-Releasing Hormones