Infusion phlebitis in patients with acute pneumonia - A prospective study

Study objectives: To prospectively assess the relative risk for phlebitis i n a series of consecutive patients with pneumonic and to identify risk fact ors that predict an increased risk for phlebitis. Setting: Internal medicine department of a tertiary teaching hospital. Patients: Seven hundred sixty-six consecutive patients wit acute pneumonia receiving IV therapy. Interventions: Only the first catheter was taken into account. There were 3 08 short lines (a 51-mm, 18-gauge Teflon catheter); 307 midsized lines (a 2 8-cm, 16-gauge polyvinyl chloride catheter); and 151 long lines (71-cm, 14- gauge plain polyurethane catheter), Eighteen variables were prospectively e valuated in an open, nonrandomized study for their contribution to the occu rrence 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 aver age (+/-SD) of 3.0 +/- 2.4 days, 4.6 +/- 3.4 days, and 7.8 +/- 6.6 days, re spectively. 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 wit either corticosteroids or eryth romycin. Conclusions: According to our data, when the use of a catheter is expected to be required for less than or equal to 36 h, a sort line can be used. If a longer duration is expected, a longer line is warranted. Ours is the firs t study in which the relationship between blood hemoglobin levels and phleb itis has been reported. Because the use of intravascular devices is increas ingly common, a more complete knowledge of the factors that influence their acceptance has become essential.