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(Chest. 1999;115:1576-1580.)
© 1999 American College of Chest Physicians

Infusion Phlebitis in Patients With Acute Pneumonia*

A Prospective Study

Manuel Monreal , MD; Francisco Quilez , RN; Celestino Rey-Joly , MD; Soledad Rodriguez , RN; Nieves Sopena , MD; Carmen Neira , RN and Josep Roca , MD

* From the Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.

Study objectives: To prospectively assess the relative risk for phlebitis in a series of consecutive patients with pneumonia and to identify risk factors that predict an increased risk for phlebitis.

Setting: Internal medicine department of a tertiary teaching hospital.

Patients: Seven hundred sixty-six consecutive patients with acute pneumonia receiving IV therapy.

Interventions: Only the first catheter was taken into account. There were 308 short lines (a 51-mm, 18-gauge Teflon catheter); 307 midsized lines (a 28-cm, 16-gauge polyvinyl chloride catheter); and 151 long lines (71-cm, 14-gauge plain polyurethane catheter). Eighteen variables were prospectively evaluated in an open, nonrandomized study for their contribution to the occurrence of phlebitis.

Results: The overall phlebitis rate was 39%. Phlebitis developed in 53% of patients with short lines, in 41% of patients with midsized lines, and in 10% of patients with long lines, and these catheters remained in place an average (± SD) of 3.0 ± 2.4 days, 4.6 ± 3.4 days, and 7.8 ± 6.6 days, respectively. The variables that influenced the development of phlebitis, as determined by multivariate analysis, were the following: type of catheter; blood hemoglobin levels; and IV therapy with either corticosteroids or erythromycin.

Conclusions: According to our data, when the use of a catheter is expected to be required for <= 36 h, a short line can be used. If a longer duration is expected, a longer line is warranted. Ours is the first study in which the relationship between blood hemoglobin levels and phlebitis has been reported. Because the use of intravascular devices is increasingly common, a more complete knowledge of the factors that influence their acceptance has become essential.

Key Words: catheter • hemoglobin • pathophysiology • phlebitis • pneumonia • prediction




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