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PubMedDate not supplied

Peripheral intravenous therapy-related phlebitis rates in an adult population.

To determine the incidence of peripheral intravenous therapy-related phlebitis in an adult population, 305 peripheral i.v. catheter sites were observed from the time of admission of the patient (or initiation of the first peripheral i.v. catheter) to the time of the participant's discharge from the facility (or 48 hours after the removal of the final catheter). Parameters monitored included patient demographics, diagnosis, i.v. fluids and medications, type of peripheral catheter, dwell time, and dressing integrity. Results showed that of the 10 cases of phlebitis found in nine study subjects, all were associated with catheters indwelling less than 72 hours. In three cases, although the catheter site was clear at the time of catheter removal, postinfusion phlebitis developed within 24 hours. Catheter site locations, diagnoses, medications, and i.v. fluids in these cases were varied.

Adult↗

PubMed2003

[Enterocolic phlebitis. Description of a case and review of the literature].

OBJECTIVE: To report about a case of enterocolic phlebitis, a rare cause of ischemic intestinal necrosis. RESULTS AND CONCLUSIONS: The patient, a 71 year-old male, presented with signs of acute abdomen. A right hemicolectomy was performed, which revealed a tubulovillous adenoma with high grade dysplasia located in the ascending colon, and a diffuse ischemic colitis. A localized lymphocytic and granulomatous phlebitis was present in the resected colon. The arteries were spared by the inflammatory process. The patient is alive and well 7 years after surgery. The literature concerning enterocolic phlebitis, a peculiar form of localized intestinal vasculitis, is briefly summarized.

Abdomen, Acute↗

PubMed2004

[How to reduce the incidence of traumatic phlebitis].

The authors carried out an analytic study on 2572 patients to reduce the occurrence of phlebitis having a traumatic cause. The authors conclude that the use of extensions after three way valves, or infusion systems and a venous catheter, considerably reduces the risk of traumatic phlebitis occurring. Furthermore, their use reduces 1. the bother patients incur, 2. the amount of work nursing professionals have derived by the appearance of traumatic phlebitis and 3. the cost of health care.

Catheterization, Peripheral↗

PubMedDate not supplied

[Stress phlebitis of the upper extremity. Medico-legal aspect].

Stress phlebitis of the upper extremity is in fact due to compression of the subclavian vein in the costo-clavicular space during certain movements, the effort being only a fortuitous component. Clinically, it evolves in two stages: at the stage of intermittent compression, the functional symptoms are related to certain positions of the upper extremity; the compression is identified clinically and with additional tests. Treatment includes physical therapy; however, persistence of the symptoms may result in having to consider the resection of the first rib. At the stage of organized phlebitis, the diagnosis is obvious although sometimes unrecognized, and the current consensus is to use anticoagulants: heparin followed by anti-vitamin K. From a medico-legal standpoint, stress phlebitis of the upper extremity is not considered a professional disease, but if it is possible to attribute it to a type of work requiring frequent upward positioning of the arms, there is an obligation for these patients to be rehabilitated professionally.

Arm↗

PubMed1985

Preventing superficial phlebitis during infusion of crystalloid solutions in surgical patients.

Thirty patients who received routine intravenous therapy (3.3% dextrose and 0.3% normal saline at a rate of 100 mL/h) were randomized prospectively into two groups to receive an antiphlebitic mixture of heparin-hydrocortisone-sodium bicarbonate or placebo in a double-blinded fashion for 4 to 7 days. The code was then broken and the data were analysed using chi 2 analysis with respect to the clinical grade and incidence of phlebitis. Phlebitis developed in 2 of 14 study and 10 of 16 control patients. All study patients tolerated their intravenous lines longer and needed less restarting. The antiphlebitic mixture effectively prevented superficial infusion phlebitis in patients receiving dextrose-saline solutions.

Anticoagulants↗

PubMedDate not supplied

[Post-phlebitis varicose veins: pathogenetic role and treatment principles].

Many clinical types can be distinguished among the post-phlebitis varicose veins : Substitution varicose veins : pre and supra pubic varicose veins that should be left intact-superficial post-phlebitis venous insufficiency which is characterized by a saphenous insufficiency that is not significantly different as a whole in its physiopathology from the essential saphenous insufficiency, and requires therefore the same forms of therapy. Superficial venous insufficiency combined with an insufficiency of communicating veins of the leg are quite frequent in post-phlebitis situations and can necessitate a special procedure on the insufficient communicating veins. Finally an isolated insufficiency of the communicating veins.

Humans↗

PubMedDate not supplied

[Primary phlebitis of the arm].

Primary phlebitis or sprain phlebitis in the upper member are caused by a compressive mechanism in the thoraco-brachial passage. Thrombosis most often originates in the area of the cost-clavicular hinge, and spreads towards the extremity of the member. In this series, 19 cases were treated: 8 recent cases of phlebitis, in which results were all too often imperfect (5 failures), 11 post-phlebitic syndromes, in which there were 9 good results. The surgical procedure which we therefore recommend aims at the decompression of the collateral circulation flowing around the thrombosed area: this should be enough to improve results in a large proportion of cases.

Arm↗

PubMed1993

[Heparinoids versus nitroglycerin in the treatment of superficial phlebitis].

The purpose of this study was to evaluate the beneficial effects of transdermal nitroglycerine (TNG) in the treatment of superficial phlebitis caused by endovenous catheters and to compare them with the effects from the application of heparinoid substances. The study performed was prospective, randomized during a six-day period. One hundred patients (73 male and 27 female), aged 28-89 years (mean 67.3), participated in the study; all presented phlebitis, diagnosed by the presence of pain, erythema, edema, and fibrous cord in the area around the catheter. Among 50 subjects, two cm of NTG gel were administered to the affected zone once a day, and for the other 50 subjects, heparinoid substances were applied three times a day. The value parameters were: time for the disappearance of pain and time for reducing erythema, edema, and fibrous cord in half (all measured in hours). We found significant differences between the two treatments with TNG yielding greater improvement in terms of disappearance of pain (TNG: 50.2 +/- 39.7, heparinoids: 72.0 +/- 39.9), time for reducing erythema in half (TNG: 28.0 +/- 24.2, heparinoids: 54.6 +/- 34.5), and time for reducing fibrous cord in half (TNG: 58.3 +/- 38.4, heparinoids: 84.5 +/- 41.5). Edema was reduce before with TNG; however, this difference was not significant (TNG: 31.2 +/- 20.3, heparinoids: 33.0 +/- 25.7). We conclude that transcutaneous TNG should be applied systematically in patients with superficial phlebitis, given that it is more effective than the usual treatment with heparinoid substances.

Adult↗

PubMedDate not supplied

[Septic phlebitis. Its consequences and its treatment].

Septic phlebitis is characterized clinically by a local syndrome in an arm, the chest or a leg, by an irregular temperature (toothsaw curve), by blood cultures that are simultaneously or successively positive for one or several pathogenic microorganisms, by repeated, multiple infected embolism and by the possibility of endocarditis as a complication. Septic phlebitis occurs either spontaneously (staphylococcosis, syndrome of angina pectoris and infarction), or through secondary infection by secondary microbial colonization of a thrombosis of gynecological or obstetrical origin or, thirdly, as the consequence of venous catheterization (perfusion, pacemaker, explorations). Prevention is based on the selection of the material (silastic piercing catheters), the choice of the site of injection, the observation of strict surgical asepsis and of choice of the fluid injected (no corticoids, nor heparin which inactivates the oligosaccharides). As regards the curative treatment, no use should be made either of heparin or of anti-inflammatory agents (especially no corticoids); first of all, the material that has caused the thrombophlebitis should be withdrawn immediately; secondly, 24 to 36 hours later, a specific antibiotic treatment should be instituted and after two weeks, if still necessary, surgical ligation may be carried out of the inferior vena cava, the subclavian vein or the brachiocephalic venous trunk, depending on the localization of the phlebitis.

Anti-Bacterial Agents↗

PubMedDate not supplied

Studies in phlebitis VIII: evaluations of pH solubilized intravenous dexverapamil formulations.

Injectable and infusion formulations of dexverapamil are evaluated for their potential to produce phlebitis. The evaluation technique utilizes two independent in vitro methods and two in vivo methods to screen a pH solubilized drug for its potential to induce phlebitis due to precipitation at the injection site. One method is based upon a theoretical calculation that simulates the change of solubility upon dilution. Its predictions are confirmed by the second method which consists of an in vitro precipitation experiment. Thermal and visual evaluations are then obtained from an in vivo rabbit ear injection. Dexverapamil formulations that have low buffering capacity are shown to contribute to the incidence of phlebitis to a greater extent than the properly buffered formulations. The calculation and the in vitro precipitation experiment are found to be useful in formulating pH solubilized parenterals. They enable the formulator to optimize pH, drug concentration, and buffer concentration without the need for animal studies. The results of this study show the importance of selecting a buffer that provides adequate buffer capacity in the formulations.

Animals↗

PubMed1997

A comparison of transparent polyurethane and dry gauze dressings for peripheral i.v. catheter sites: rates of phlebitis, infiltration, and dislodgment by patients.

BACKGROUND: Before a meta-analysis by Hoffman et al was published, polyurethane dressings were used at insertion sites for peripheral i.v. catheters at our institution. On the basis of the results of the meta-analysis, we began to use gauze dressings. The change from polyurethane dressings to gauze dressings limited direct observation of the i.v. insertion site, and i.v. catheters were anecdotally reported not to be anchored as securely as before. OBJECTIVES: The purpose of this study was to compare the effects of the use of transparent polyurethane dressings and gauze dressings at insertion sites for peripheral i.v. catheters on the frequency of phlebitis, infiltration, and catheter dislodgment by patients. METHODS: Two hundred twenty-nine patients were randomized to receive either gauze (n = 121) or transparent polyurethane (n = 108) dressings, and observations were recorded. RESULTS: The frequency of catheter dislodgment by the patient was significantly higher (P < .05) in patients with the gauze dressing (15%) than in patients with the transparent polyurethane dressing (6%). A trend toward lower frequencies of phlebitis (1.8% vs 3.3%) and infiltration (17.6% vs 20.7%) was noted in the patients with the transparent polyurethane dressings. DISCUSSION: The clinical advantages of the transparent polyurethane dressings lie in the ease of direct visualization of the i.v. insertion site and the securement of the i.v. catheter. CONCLUSION: At our institution, given the decreased disruption of the i.v. therapy with the transparent polyurethane dressings and the lack of differences in the rates of phlebitis or infiltration with the two types of dressings, we prefer to use transparent polyurethane rather than gauze dressings at insertion sites for peripheral i.v. catheters.

Catheterization, Peripheral↗

PubMed1976

Double-blind evaluation of 5-mum final filtration to reduce postinfusion phlebitis.

A double-blind study was conducted to determine the effectiveness of 5-mum final filtration in preventing phlebitis secondary to intravenous fluid administration. An experimental administration set which contained distal portion of the tubing was used for patients randomly assigned to receive filtered intravenous solutions. An identical administration set minus the filter was used in the control group to allow double-blind evaluation of the injection site. Data were collected on 49 patients whose average age was eight years and one month. Most patients had a primary diagnosis of acute lymphocytic or myelocytic leukemia or solid tumor. The patients' injection sites were evaluated daily for clinical findings of phlebitis (erythema, induration, heat, erythematous-streak and discomfort). The incidence of phlebitis was significantly lower (p less than 0.01) in patients receiving filtered intravenous solutions. For the patients in this study, filtration of intravenous fluids with a 5-mum mesh filter appeared to be a feasible and effective means of reducing postinfusion complications.

Drug Contamination↗

PubMed2002

[Pseudotumoral enterocolic phlebitis of the cecum and rutoside. A case report].

INTRODUCTION: Enterocolic phlebitis is an entity characterized by ischemic injury of the gastrointestinal tract caused by thrombophlebitis of the mesenteric veins without arterial involvement or systemic disease. EXEGESIS: We report a case of enterocolic phlebitis in a 57-year-old female treated by rutoside, revealed by intestinal obstruction related to a pseudotumoral lesion of the caecum. CONCLUSION: This case adds to the four cases of enterocolic phlebitis under rutoside already reported in the literature, suggesting a possible involvement of this drug in this rare disease.

Cecal Diseases↗

PubMed1993

[Phlebitis of the upper limbs on pacemaker electrodes. 4 cases and review of the literature].

We report four cases of deep venous thrombosis of the upper extremity, which occurred in two women and two men (mean age 79 years) in whom a pacemaker electrode had been inserted 4 years on averages previously. In three of these four cases phlebitis developed after immobilization of the limb containing the electrode. Deep venous thrombosis of the upper extremity is rare, but 28% of catheterizations are responsible for phlebitis. One to 3% of patients fitted with a pacemaker have symptomatic phlebitis, but these figures rise to 28-65% when phlebography is systematically performed in subjects wearing a pacemaker. The clinical signs are the same as those of the classical forms, and the diagnosis is made by doppler-ultrasonography and by phlebography which informs on the collateral circulation. Cure is obtained with efficient anticoagulant therapy. These cases prompt us to prescribe a preventive subcutaneous heparin therapy in those pacemaker-fitted subjects whose arm is immobilized. The heparin dosage remains to be determined precisely.

Aged↗

PubMed2002

A dedicated intravenous cannula for postoperative use effect on incidence and severity of phlebitis.

A prospective, randomised, controlled clinical study was performed to compare the incidence and severity of postoperative peripheral venous thrombophlebitis associated with a single intravenous cannula used for both intra-operative and postoperative purposes, and two cannulae, one used intra-operatively and the other postoperatively. Sixty American Society of Anaesthesiologists (ASA) physical status I or II patients aged 18-65 years undergoing elective surgery were studied. The technique of cannula insertion was standardised. After surgery, the cannulation sites were examined daily by a blinded investigator for the presence and severity of thrombophlebitis using the Baxter Scale. The two groups were similar in terms of age, gender, weight, type and duration of surgical procedures, and drugs and fluids administered both intra-operatively and postoperatively. The proportion of patients that developed phlebitis was significantly less in the two cannulae group (26.1%) than in the single cannula group (63.3%) (p < 0.0001). The severity of phlebitis was greater in the single cannula group than in the two cannulae group. These results indicate that the use of a dedicated cannula for postoperative use decreases the incidence and severity of postoperative, peripheral, cannula-related phlebitis.

Adult↗

PubMedDate not supplied

The Teflon intravenous catheter: incidence of phlebitis and duration of catheter life in the neonatal patient.

The risks and benefits of intravenous therapy for neonatal patients have not been adequately evaluated. A study was conducted to assess the duration of life of the Teflon catheter used for intravenous therapy in neonates, the incidence of phlebitis associated with this catheter, and the factors which contribute to catheter life and phlebitis. Seventy-two neonates undergoing intravenous therapy with the Teflon catheter were studied. Study results indicated a mean catheter life of 30.1 hours, with 33 of the 72 catheters lasting less than 24 hours. Erythema occurred in 32 cases and phlebitis occurred in 5 cases. Of 19 predictor variables studied, low level of activity and administration of blood transfusion through the catheter were positively correlated with duration of catheter life. The Teflon catheter offers a reasonable though limited means for intravascular access in neonates.

Birth Weight↗

PubMedDate not supplied

The impact of an i.v. team on the occurrence of intravenous-related phlebitis. A 30-month study.

A 30-month study of intravenous cannulation performed by I.V. team and non-I.V. team personnel demonstrates a significant and unpredictable benefit of an I.V. team. Beneficial effects include decreased volume and severity of phlebitis after infusion. The benefit appears to be most consistent on Medicine and Neuroscience services, inconsistent on Surgery and Obstetric/Gynecologic services, and not perceivable in Intensive Care Unit. The primary benefit appears to occur on those services that require the largest volume of venipunctures; these units account for approximately one half of all venipunctures performed. I.V. team benefit correlates well with increased team activity and, in contrast to other reports, does not correlate well with increasing incidence of phlebitis or cannula dwell time. A cost savings of approximately $17,000 per year related to a reduction in intravenous-related phlebitis due to I.V. team activity was demonstrated.

Humans↗

PubMed1990

[Isolated recurrent superficial steroid-induced phlebitis of the lower limbs in young women. A new entity].

The authors report 3 personal cases of recurrent, strictly superficial phlebitis of the lower limbs which developed in young women and responded dramatically to corticosteroid therapy. The phlebitis was oestrogen dependent: it has started during pregnancy and was exacerbated in the second part of the menstrual cycle. Clinically, the disease presented as red, dilated veins and/or isolated inflammatory nodules mimicking acute nodular panniculitis. Histology confirmed the diagnosis by showing a major polymorphous inflammatory infiltrate in the venous wall and extending well beyond it, and an intraluminal occasionally occlusive thrombus. A search for thrombosis-inducing diseases, such as disorders of coagulation or fibrinolysis, connective tissue disease, neoplasia or infraction, was negative. Since the phlebitis was strongly inflammatory, frequently recurred and resisted numerous treatments, systemic corticosteroid therapy was instituted, resulting in a dramatic improvement. The steroids were then successfully replaced by antiplatelet agents or, because of the oestrogen dependence, cyproterone maleate. After a mean follow-up period of 2 years, the patients are doing well.

Adrenal Cortex Hormones↗