Peripheral IV Cannulas Linked to Higher Phlebitis Rates

The incidence of phlebitis caused by peripheral intravenous (IV) cannula insertions may be higher among patients with certain risk factors, claims a new study.

Researchers at the University of Novi Sad (Serbia) conducted an observational study that prospectively observed 1,428 peripheral IV cannula insertions in 368 adult hospitalized inpatients at Novi Sad health care clinics. Data collected included patients’ medical information; data related to each cannula insertion, including placement, monitoring, and the reasons for removal; and administered medications and solutions. The results revealed that phlebitis ranked first among complications with an occurrence of 44%, followed by infiltration (16.3%), occlusion (7.6%), and catheter dislodgement (5.6%).

The results showed that the risk for phlebitis was higher with comorbidities, current infection, catheter size, time in situ, and the total number of infusion solutions administered. Infiltration risk also increased with 20-gauge catheters, two or more attempts at cannulation, and administration of high-risk solutions during the first day of hospitalization. The most common individual complications were medium stage phlebitis and grade two infiltrations. The study was published on December 27, 2018, in the Journal of Clinical Nursing.

“Incidence of infiltration, occlusion, and dislodgment is almost congruent with the average incidence of previous studies. However, the incidence and degree of severity associated with the occurrence of phlebitis were significantly higher,” concluded lead author Dragana Simin, PhD, RN, of the department of nursing, and colleagues.

Phlebitis and thrombosis of superficial veins in the legs (also known as superficial thrombophlebitis) is generally a benign, self-limited disorder; however, when the larger axial veins are involved, such as in superficial vein thrombosis (SVT), propagation into the deep vein system can occur, resulting in deep vein thrombosis (DVT), and even pulmonary embolism. Treatment is aimed at relieving local symptoms and preventing thromboembolic complications.

Related Links:
University of Novi Sad