title: Experimental infusion phlebitis: tolerance osmolality of peripheral venous endothelial cells.
abstract: This study aimed to determine the osmolality that peripheral venous endothelial cells can tolerate and to clarify the relationship between tolerance osmolality and duration of infusion. Nutrient solutions of 539-917 mOsm/kg, prepared to have no acidic effect, were infused into rabbit ear veins, and the veins were examined histopathologically. In each experiment of 8-, 12-, or 24-h infusion, the higher osmolality solutions caused some phlebitic changes, such as loss of venous endothelial cells, inflammatory cell infiltration, and edema; however, the lowest osmolality solution caused few changes. Infusion of 120 mL/kg of 814 mOsm/kg solution caused phlebitis at 5 or 10 mL.kg-1.h-1, however, the same volume of the same solution scarcely caused phlebitis at 15 mL.kg-1.h-1 because of the shortened infusion duration. These results suggest that the tolerance osmolality of peripheral venous endothelial cells with poor blood flow is about 820 mOsm/kg for 8 h, 690 mOsm/kg for 12 h, and 550 mOsm/kg for 24 h, and that the tolerance osmolality falls as the duration of infusion increases. In conclusion, hypertonic solutions should be infused at as high a rate as is clinically acceptable and compatible with nutrient bioavailability because increasing the infusion rate reduces the duration of infusion and phlebitis.
authors.affiliation: Naruto Research Institute, Otsuka Pharmaceutical Factory, Inc., Tokushima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kuwahara
authors.forename: S
authors.initials: S
authors.lastname: Asanami
authors.forename: S
authors.initials: S
authors.lastname: Kubo
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage; D000818:Animals; D004423:Ear / Q000098:blood supply; D004730:Endothelium, Vascular / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D005947:Glucose / Q000008:administration & dosage; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008297:Male; D009994:Osmolar Concentration; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010689:Phlebitis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D011817:Rabbits; D013997:Time Factors; D014680:Veins / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology
chemical_list: D000596:Amino Acids; D005947:Glucose