Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T08:18:07.372Z Has data issue: false hasContentIssue false
  • English
  • Français

Optimal Frequency of Changing Intravenous Administration Sets: Is It Safe to Prolong Use Beyond 72 Hours?

Published online by Cambridge University Press:  02 January 2015

Issam Raad ,
Hend A. Hanna ,
Abeer Awad ,
Amin Alrahwan ,
Carol Bivins ,
Asma Khan ,
Deborah Richardson ,
Jan L. Umphrey ,
Estella Whimbey  and
Georganne Mansour
Issam Raad*
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Hend A. Hanna
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Abeer Awad
Affiliation:
St Joseph's Hospital and Medical Center, Paterson, New Jersey
Amin Alrahwan
Affiliation:
University of Texas Health Science Center, Department of Pathology, San Antonio, Texas
Carol Bivins
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Asma Khan
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Deborah Richardson
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Jan L. Umphrey
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Estella Whimbey
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
Georganne Mansour
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas
*
The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Houston, TX 77030
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the safety and cost-effectiveness of replacing the intravenous (TV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours.

Design:

Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within 4 to 7 days of placement.

Setting:

A tertiary university cancer center.

Patients and Methods:

Cancer patients requiring IV infusion therapy were randomized to have the IV tubing sets replaced within 3 days (280 patients) or within 4 to 7 days of placement (232 patients). Demographic, microbiological, and infusion-related data were collected for all participants. The main outcome measures were infusion- or catheter-related contamination or colonization of IV tubing, determined by quantitative cultures of the infusate, and infusion- or catheter-related bloodstream infection (BSI), determined by quantitative culture of the infusate in association with blood cultures in febrile patients.

Results:

The two groups were comparable in terms of patient and catheter characteristics and the agents given through the IV tubing. Intent-to-treat analysis demonstrated a higher level of tubing colonization in the 4- to 7-day group versus the 3-day group (median, 145 vs 50 colony-forming units; P=.02). In addition, there were three episodes of possible infusion-related BSIs, all of which occurred in the 4- to 7-day group (P=.09). However, when the 84 patients who received total parenteral nutrition, blood transfusions, or interleukin-2 through the IV tubing were excluded, the two groups had a comparable rate of colonization (0.4% vs 0.5%), with no catheter- or infusion-related BSIs in either group.

Conclusion:

In patients at low risk for infection from infusion- or catheter-related infection who are not receiving total parenteral nutrition, blood transfusions, or interleukin-2, delaying the replacement of IV tubing up to 7 days may be safe, as well as cost-effective.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 3 , March 2001 , pp. 136 - 139
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Pearson, ML, the Hospital Infection Control Practices Advisory Committee. Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol 1996;17:438–473.Google Scholar
2. Maki, DG, Stolz, SM, Wheeler, S, Mermel, LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann Intern Med 1997;127:257–266.CrossRefGoogle ScholarPubMed
3. Maki, DG, Rhame, FS, Mackel, DC, Bennett, JV. Nationwide epidemic of septicemia caused by contaminated intravenous products. Am J Med 1976;60:471–485.Google Scholar
4. Centers for Disease Control and Prevention. Nosocomial bacteremia associated with intravenous fluid therapy. MMWR 1971;20(suppl 9):1–2.Google Scholar
5. Buxton, AE, Highsmith, AK, Garner, JS, West, CM, Stamm, WE, Dixon, RE, et al. Contamination of intravenous fluid: effects of changing administration sets. Ann Intern Med 1979;90:764–768.CrossRefGoogle ScholarPubMed
6. Band, JD, Maki, DG. Safety of changing intravenous delivery systems at longer than 24-hour intervals. Ann Intern Med 1979;91:173–178.Google Scholar
7. Gorbea, HE, Snydman, DR, Delaney, A, Stockman, J, Martin, WJ. Intravenous tubing with burettes can be safely changed at 48-hour intervals. JAMA 1984;251:2112–2115.Google Scholar
8. Snydman, DR, Donnelly-Reidy, M, Perry, LK, Martin, WJ. Intravenous tubing containing burettes can be safely changed at 72-hour intervals. Infect Control 1987;8:113–116.Google Scholar
9. Maki, DG, Botticelli, JT, LeRoy, ML, Thielke, TS. Prospective study of replacing administration sets for intravenous therapy at 48- vs 72-hour intervals. 72 hours is safe and cost-effective. JAMA 1987;258:1777–1781.CrossRefGoogle ScholarPubMed
10. Josephson, A, Gombert, ME, Sierra, MF, Karanfil, LV, Tansino, GF. The relationship between intravenous fluid contamination and the frequency of tubing replacement. Infect Control 1985;6:366–370.Google Scholar
11. Snydman, DR, Sullivan, B, Gill, M, Gould, JA, Parkinson, DR, Atkins, MB. Nosocomial sepsis associated with interleukin-2. Ann Intern Med 1990;112:102–107.Google Scholar
12. Pockaj, BA, Topalian, SL, Steinberg, SM, White, DE, Rosenbert, SA. Infectious complications associated with interleukin-2 administration: a retrospective review of 935 treatment courses. J Clin Oncol 1993;11:136–147.Google Scholar
13. Richards, JM, Gilewski, TA, Vogelzang, NJ. Association of interleukin-2 therapy with staphylococcal bacteremia. Cancer 1991;67:1570–1575.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
14. Lim, SH, Giles, FJ, Smith, MP, Goldston, AH. Bacterial infections in lymphoma patients treated with recombinant interleukin-2. Acta Haematol 1991;85:135–138.Google Scholar
15. Raad, II, Hachem, RY, Abi-Said, D, Rolston, KV, Whimbey, E, Buzaid, AC, et al. A prospective crossover randomized trial of novobiocin and rifampin prophylaxis for the prevention of intravascular catheter infections in cancer patients treated with interleukin-2. Cancer 1998;82:403–411.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
16. Matlow, AG, Kital, I, Kirpalani, H, Chapman, NH, Corey, M, Perlman, M, et al. A randomized trial of 72- versus 24-hour intravenous tubing set changes in newborns receiving lipid therapy. Infect Control Hosp Epidemiol 1999;20:487–493.Google Scholar