Baptista R J, Driscoll D F, Gallagher J A, O'Keefe E, Dumas G J, Hammer S M, Pacella P P
Deaconess Home Health Care, Boston, MA 02215.
Clin Pharm. 1987 Apr;6(4):314-8.
The occurrence of infusion phlebitis in patients receiving intravenous antibiotics via a gravity-feed minibottle system versus a new syringe-pump system was compared. Patients at least 18 years old who had indwelling intermittent injection sites inserted for medication administration were randomized to either the minibottle system or the syringe-pump system. Antibiotics in minibottles were diluted in 50-100 mL of 5% dextrose injection; in the syringe-pump group, aminoglycoside antibiotics were diluted in 0.9% sodium chloride injection and all other antibiotics were diluted in sterile water for injection. Antibiotics were not piggybacked into running primary infusions in any of the study patients, and no other medications except for 0.9% sodium chloride flushes were administered through the catheters. All catheters were inserted in peripheral veins and evaluated for phlebitis by i.v. nurse specialists using standardized criteria. Catheters were changed upon the occurrence of grade 1 phlebitis or after a period of three days without the development of phlebitis. Over an 18-week period, 85 catheter sites (53 syringe-pump group versus 32 minibottle group) were evaluated in 30 patients (14 syringe-pump group versus 16 minibottle group). The mean +/- S.D. catheter life in both groups was 50.6 +/- 20 hours. Phlebitis occurred in 62% of syringe-group sites versus 66% of minibottle-group sites; the incidence and severity of phlebitis were not significantly different between groups. The majority of catheter sites were infused with cefazolin sodium. The potential for phlebitis using the syringe-pump system in this study appears to be similar to that of the gravity-feed minibottle system when appropriate diluents, diluent volumes, and infusion rates are used.
比较了通过重力输注微型瓶系统与新型注射器泵系统接受静脉抗生素治疗的患者中输注性静脉炎的发生率。年龄至少18岁且有用于药物给药的留置间歇性注射部位的患者被随机分为微型瓶系统组或注射器泵系统组。微型瓶中的抗生素用50 - 100 mL的5%葡萄糖注射液稀释；在注射器泵组中，氨基糖苷类抗生素用0.9%氯化钠注射液稀释，所有其他抗生素用注射用水稀释。在任何研究患者中，抗生素均未与正在进行的主要输液同时输注，并且除了0.9%氯化钠冲洗液外，没有通过导管给予其他药物。所有导管均插入外周静脉，并由静脉护士专家使用标准化标准评估静脉炎情况。在出现1级静脉炎时或在未发生静脉炎的三天后更换导管。在18周的时间里，对30名患者（14名注射器泵组患者和16名微型瓶组患者）的85个导管部位（53个注射器泵组部位和32个微型瓶组部位）进行了评估。两组导管的平均使用时长±标准差为50.6±20小时。注射器组部位发生静脉炎的比例为62%，微型瓶组部位为66%；两组之间静脉炎的发生率和严重程度没有显著差异。大多数导管部位输注的是头孢唑林钠。在本研究中，当使用适当的稀释剂、稀释剂体积和输注速率时，使用注射器泵系统发生静脉炎的可能性似乎与重力输注微型瓶系统相似。
