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
Setting: Internal medicine department of a
tertiary teaching hospital.
Patients: Seven hundred
sixty-six consecutive patients with acute pneumonia receiving IV
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