No difference in phlebitis incidence with clinically-indicated versus routine third-day replacement
FRIDAY, Sept. 21 (HealthDay News) -- Replacement of peripheral intravenous catheters as clinically indicated is as safe as routine replacement, according to a study published in the Sept. 22 issue of The Lancet, a theme issue on surgery.
To examine whether clinically-indicated catheter replacement is of equal benefit to routine replacement, Claire M. Rickard, Ph.D., from Griffith University in Nathan, Australia, and colleagues conducted a multicenter trial involving 3,283 adults (18 years and older) with an intravenous catheter of expected use of more than four days. Participants were randomized in a 1:1 ratio to clinically-indicated catheter replacement (1,593 patients) or third daily routine replacement (1,690 patients). The equivalence margin was set at 3 percent.
The researchers found that, when replaced as clinically indicated, the mean catheter dwell time in situ on day three was 99 hours, compared with 70 hours when routinely replaced. The absolute difference in phlebitis between the two groups was 0.41 percent (114 of 1,593 patients [7 percent] in the clinically-indicated group versus 114 of 1,690 patients [7 percent] in the routine-replacement group), which was within the prespecified equivalence margin. There were no serious adverse events reported related to the study intervention.
"Peripheral intravenous catheters can be removed as clinically indicated; this policy will avoid millions of catheter insertions, associated discomfort, and substantial costs in both equipment and staff workload," the authors write. "Ongoing close monitoring should continue with timely treatment cessation and prompt removal for complications."
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