In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

Abstract

Background:

In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration.

Methods:

We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access.

Results:

In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay.

Conclusion:

In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

Keywords

Particles phlebitis peripheral venous cannulation cost analysis perioperative medicine

Get full access to this article

View all access options for this article.

References

Niel-Weise

Stijnen

vandenBroek

PJ.

Should in-line filters be used in peripheral intravenous catheters to prevent infusion-related phlebitis? A systematic review of randomized controlled trials. Anesth Analg 2010; 110(6): 1624–1629.

Tagalakis

Kahn

Libman

, et al. The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med 2002; 113(2): 146–151.

Pasalioglu

Kaya

Catheter indwell time and phlebitis development during peripheral intravenous catheter administration. Pak J Med Sci 2014; 30(4): 725–730.

Nassaji-Zavareh

Ghorbani

Peripheral intravenous catheter-related phlebitis and related risk factors. Singapore Med J 2007; 48(8): 733–736.

Pikwer

Åkeson

Lindgren

, et al. Complications associated with peripheral or central routes for central venous cannulation. Anaesthesia 2012; 67(1): 65–71.

Ball

Bethune

Fox

, et al. Particulate contamination in parenteral nutrition solutions: still a cause for concern. Nutrition 2001; 17(11–12): 926–929.

Falchuk

Peterson

LMB

. Microparticulate-induced phlebitis: its prevention by in-line filtration. N Eng J Med 1985; 312(2): 78–82.

Trautmann

Zauser

Wiedeck

, et al. Bacterial colonization and endotoxin contamination of intravenous infusion fluids. J Hosp Infect 1997; 37(3): 225–236.

Stromberg

Wahlgren

Saving money with effective in-line filters. Intensive Care Nurs 1989; 5(3): 109–113.

10.

Spencer

RC.

Use of in-line filters for intravenous infusions. J Hosp Infect 1990; 16(3): 281.

11.

Vanhaecke

DeMuynck

Remon

, et al. Endotoxin removal by end-line filters. J Clin Microbiol 1989; 27(12): 2710–2712.

12.

Villa

Chelazzi

Giua

, et al. In-line filtration reduces postoperative venous peripheral phlebitis associated with cannulation: a randomized clinical trial. Anesth Analg 2018; 127: 1367–1374.

13.

Rickard

Marsh

Webster

, et al. Securing all intravenous devices effectively in hospitalised patients – the SAVE trial: study protocol for a multicentre randomised controlled trial. BMJ Open 2015; 5(9): e008689.

14.

Backhouse

Ball

Booth

, et al. Particulate contaminants of intravenous medications and infusions. J Pharm Pharmacol 1987; 39(4): 241–245.

15.

Ball

PA.

Intravenous in-line filters: filtering the evidence. Curr Opin Clin Nutr Metab Care 2003; 6(3): 319–325.

16.

Friedland

Infusion-related Phlebitis – is the in-line filter the solution?

N Eng J Med 1985; 312(2): 113–115.

17.

Van Den Hoogen

Krediet

Uiterwaal

, et al. In-line filters in central venous catheters in a neonatal intensive care unit. J Perinat Med 2006; 34(1): 71–74.