Infusion phlebitis in patients with acute pneumonia: a prospective study.
OBJECTIVE
To prospectively assess the relative risk for phlebitis in a series of consecutive patients with pneumonia and to identify risk factors that predict an increased risk for phlebitis.


METHODS
Internal medicine department of a tertiary teaching hospital.


METHODS
Seven hundred sixty-six consecutive patients with acute pneumonia receiving IV therapy.


METHODS
Only the first catheter was taken into account. There were 308 short lines (a 51-mm, 18-gauge Teflon catheter); 307 midsized lines (a 28-cm, 16-gauge polyvinyl chloride catheter); and 151 long lines (71-cm, 14-gauge plain polyurethane catheter). Eighteen variables were prospectively evaluated in an open, nonrandomized study for their contribution to the occurrence of phlebitis.


RESULTS
The overall phlebitis rate was 39%. Phlebitis developed in 53% of patients with short lines, in 41% of patients with midsized lines, and in 10% of patients with long lines, and these catheters remained in place an average (+/- SD) of 3.0+/-2.4 days, 4.6+/-3.4 days, and 7.8+/-6.6 days, respectively. The variables that influenced the development of phlebitis, as determined by multivariate analysis, were the following: type of catheter; blood hemoglobin levels; and IV therapy with either corticosteroids or erythromycin.


CONCLUSIONS
According to our data, when the use of a catheter is expected to be required for < or = 36 h, a short line can be used. If a longer duration is expected, a longer line is warranted. Ours is the first study in which the relationship between blood hemoglobin levels and phlebitis has been reported. Because the use of intravascular devices is increasingly common, a more complete knowledge of the factors that influence their acceptance has become essential.
Monreal
M
M
Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain. mmonreal@ns.hugtip.scs.es
Quilez
F
F
Rey-Joly
C
C
Rodriguez
S
S
Sopena
N
N
Neira
C
C
Roca
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010689:Phlebitis / Q000209:etiology*; D011014:Pneumonia / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids