Peripheral venous catheter-related inflammation. A randomized prospective trial.

BACKGROUND

Peripheral venous catheter-related inflammation (PVCRI) is a serious health and economic issue. It is mainly linked to peripheral venous catheter (PVC) duration and other risk factors.

METHODS

PVCRI was prospectively evaluated in a 3 month-study according to PVC duration. Other risk factors were also studied such as age, gender, diabetes, intravenous steroids and antibiotics. 221 patients admitted to 3 different departments in a university hospital were randomized to undergo a 72 hours versus 96 hours PVC. The primary endpoint was to evaluate if this prolonged duration would increase the incidence of lymphangitis. The secondary endpoints were to evaluate if other risk factors such as age, gender, diabetes, intravenous steroids and antibiotics, have a direct impact on lymphangitis. Fever, local inflammatory signs and date of occurrence have been noted by two different nurses. The Stata 8.0 program, and the Pearson chi-square test to compare percentages (alpha = 0.05) were used.

RESULTS

PVCRI occurred in 20.4% of all studied patients. PVCRI incidence did not differ between the patients who kept the catheter for 72 hours and those who kept it for 96 hours, but we found a significantly increasing incidence of PCVRI while comparing 24 hours versus 48 hours duration and 24-48 hours duration versus 72-96 hours duration respectively. Age, as well as intravenous antibiotherapy showed to be a significant risk factor for PVCRI. As for diabetic patients, there was a trend towards a higher incidence of PVCRI. Intravenous steroids showed to have a beneficial effect. It is to be noted that the rate of PVCRI was significantly higher in the internal medicine/infectious diseases department compared to the two other departments.

CONCLUSION

No difference on PVCRI risk was found between 72 and 96 hours catheter duration. However the risk seems to increase between the first and the third day of catheterization. We suggest that an adapted duration of the PVC to the patient risks would be more cost-effective.