Intravenous peripheral catheter dwell times : randomised controlled trial of hospital in-patients

摘要

BackgroundududThere is currently no high grade evidence on which to base decisions about the frequency of intravenous cannula re-sitesududObjectiveududTo assess the safety of changing peripheral venous cannulas when clinically indicatedududDesignududRandomised controlled trial Setting: A tertiary referral hospital in Brisbane, Australia Participants: 206 hospitalised patients from surgical, medical and orthopaedic wardsududInterventionsududPeripheral intravenous cannulas were re-sited only when complications occurred (intervention group) or every 3 days (control group). Main outcome measures: The primary endpoint was a composite measure of complications leading to an unplanned cannula removal, the secondary outcome was cost. Results: Forty six patients had unplanned removals in the intervention group compared with 41 in the control group [relative risk 1.12, 95% confidence interval 0.81 to 1.55 (p = 0.286)]. Total duration of peripheral cannulation was similar in both groups (mean 123.3 hours in the intervention group and 125.9 hours in the control group: P = 0.82) but significantly more re-sites occurred in the control group (167 in intervention group, 202 in the control group: p = 0.022). Cost of cannula replacements in the intervention group was AUD$3,183.62 and in the control group AUD$3,837.56 (p = 0.006). After adjustment for other risk factors, frequency of cannulation [odds ratio (OR) 0.78. 95% confidence interval (CI) 0.27 – 0.22], total duration of cannulation (OR 1.01. CI 1.00 – 1.02) and irritability of IV medications other than antibiotics (OR 0.45, CI 0.21 – 0.97) were positively associated with unplanned cannula removal. ududConclusionududRe-siting peripheral venous cannulas when clinically indicated compared with changing them routinely every 3 days does not lead to more complications and reduces costs.