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Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients.
- Source :
-
Trials . 7/26/2016, Vol. 17, p1-10. 10p. 1 Diagram, 3 Charts, 1 Graph. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Research has identified high failure rates of peripheral intravenous catheter (PIVC) and varied flushing practices.<bold>Methods: </bold>This is a single-centre, pilot, non-masked, factorial randomised controlled trial. Participants were adults, with a PIVC of expected use ≥24 hours (n = 160), admitted to general medical or surgical wards of a tertiary referral hospital in Queensland (Australia). Patients were randomly allocated to one of four flush groups using manually prepared syringes and 0.9 % sodium chloride: 10 mL or 3 mL flush, every 24 or 6 hours. The primary endpoint was PIVC failure, a composite measure of occlusion, infiltration, accidental dislodgement and phlebitis.<bold>Results: </bold>PIVC average dwell was 3.1 days. PIVC failure rates per 1000 hours were not significantly different for the volume intervention (4.84 [3 mL] versus 7.44 [10 mL], p = 0.06, log-rank). PIVC failure rates per 1000 hours were also not significantly different for the frequency intervention (5.06 [24 hour] versus 7.34 [6 hour], p = 0.05, log-rank). Cox proportional hazard regression found neither the flushing nor frequency intervention, or their interaction (p = 0.21) to be significantly associated with PIVC failure. However, female gender (hazard ratio [HR] 2.2 [1.3-3.6], p < 0.01), insertion in hand/posterior wrist (HR 1.7 [1.0-2.7], p < 0.05) and the rate per day of PIVC access (combined flushes and medication pushes) (HR 1.2 [1.1-1.4], p < 0.01) significantly predicted PIVC failure.<bold>Conclusion: </bold>Neither increased flushing volume nor frequency significantly altered the risk of PIVC failure. Female gender, hand/posterior wrist placement and episodes of access (flushes and medication) may be more important. Larger, definitive trials are feasible and required.<bold>Trial Registration: </bold>Australian and New Zealand Clinical Trials Registry: ACTRN12615000025538 . Registered on 19 January 2015. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INTRAVENOUS catheterization complications
*VASCULAR endothelium
*HEALTH outcome assessment
*PHLEBITIS
*SURGICAL hospitals
*ARTERIAL occlusions
*HEALTH of adults
*RANDOMIZED controlled trials
*PREVENTION
*BLOOD vessels
*CATHETERS
*COMPARATIVE studies
*INTRAVENOUS catheterization
*IRRIGATION (Medicine)
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL equipment
*RESEARCH
*SALT
*SEX distribution
*TIME
*PILOT projects
*EVALUATION research
*SPECIALTY hospitals
*TREATMENT effectiveness
*PROPORTIONAL hazards models
*MEDICAL equipment reliability
*KAPLAN-Meier estimator
*EQUIPMENT & supplies
Subjects
Details
- Language :
- English
- ISSN :
- 17456215
- Volume :
- 17
- Database :
- Academic Search Index
- Journal :
- Trials
- Publication Type :
- Academic Journal
- Accession number :
- 117046575
- Full Text :
- https://doi.org/10.1186/s13063-016-1470-6