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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
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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

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