Risks associated with 72- and 96-hour peripheral intravenous catheter dwell times.
BACKGROUND
The risk of complications in peripheral intravenous therapy is higher on the second day of therapy and may continue to increase with time, making routine restarts after 3 days a common practice. The objective of the study was to determine whether the risks of complications after a peripheral i.v. catheter restart after 72 hours are less than the risks of complications if the therapy is continued to 96 hours.


METHODS
A retrospective chart review was completed for 722 patients in a community hospital with peripheral i.v. catheters for i.v. fluids or saline locks. Measurements collected were i.v. therapy start date, number of restarts, termination date, and reason for termination; the data were analyzed using risk models.


RESULTS
There were 596 uncomplicated therapies. Complications prompted termination in 188 cases. The average duration of therapy was 1.8 days. The probability of complications was least in the first 24 hours, (0.074; standard deviation [SD], 0.013), and increased to 0.176 (SD, +/- 0.026) in the 24- to 48-hour period. The probability of a complication in the 48- to 72-hour period and the 72- to 96-hour period was 0.130 (SD, 0.026). A restarted catheter has a significantly higher risk of complication in its first 24 hours than does an initial catheter.


CONCLUSIONS
From these results, the authors conclude that restarting catheters at 72 hours does not reduce the risk of complication in the next 24 hours when compared with simply continuing the therapy with the original catheter. Additional studies should be conducted to justify a policy of automatically restarting therapy after 72 hours.
Homer
L D
LD
Legacy Health System, Portland, Oregon, USA.
Holmes
K R
KR
D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000191:economics / Q000451:nursing / Q000523:psychology; D017046:Cost Savings; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000191:economics / Q000451:nursing / Q000523:psychology; D017060:Patient Satisfaction; D010689:Phlebitis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors