Intravascular administration sets are accurate and in appropriate condition after 7 days of continuous use: an in vitro study.

BACKGROUND The ideal duration of intravascular administration set use is unknown. Studies have compared the infective implications of 1--7 days of use. The Centers for Disease Control recommend at least 3 days usage. No previous study has evaluated the accuracy of volume delivery or integrity of administration sets after prolonged use. AIM To evaluate the accuracy and condition of intravascular administration sets used continuously for 7 days. DESIGN Prospective, randomized, experimental study in the laboratory setting. METHODS Four administration sets were randomly assigned to deliver 2 mL/hour (IMEDreg syringe set 2280--0000), 20, 50 or 100 mL/hour (IMEDreg infusion sets 2210--0500) of crystalloid solution continuously for 7 days through an IMEDreg Geminireg four channel infusion pump (PC4). At study commencement and daily for 7 days, a 4-hour volume measurement and an inspection for leaks/erosion of administration sets occurred for each administration set (total measurements = 32). RESULTS Mean volume outputs over 4 hours were 7.84 mL (2 mL/hour), 80.66 mL (20 mL/hour), 205.35 (50 mL/hour) and 406.37 (100 mL/hour). These differed significantly from the programmed volumes (P=0.00--0.01). Usage duration did not influence performance (F=0.866, P=0.55). Accuracy of volume delivery differed significantly with pump speed (F=106.933, P < 0.001) exhibiting increased volume to 50 mL/hour then a reduction at 100 mL/hour. Differences were within manufacturer specifications (+/-5%) and were clinically acceptable. All administration sets remained in appropriate condition displaying no leakage or erosion. CONCLUSION There were small inaccuracies found between programmed and delivered volumes, however, there was no deterioration in performance over time. This suggests that inaccuracies were because of normal pump performance rather than the administration sets. Administration sets retain acceptable accuracy and condition after 7 days continuous use. Further research should assess the infective and other impacts of prolonged usage.

[1]  I. Raad,et al.  Optimal Frequency of Changing Intravenous Administration Sets: Is It Safe to Prolong Use Beyond 72 Hours? , 2001, Infection Control &#x0026; Hospital Epidemiology.

[2]  M. Corey,et al.  A Randomized Trial of 72- Versus 24-Hour Intravenous Tubing Set Changes in Newborns Receiving Lipid Therapy , 1999, Infection Control &#x0026; Hospital Epidemiology.

[3]  Rabih Darouiche,et al.  Central Venous Catheters Coated with Minocycline and Rifampin for the Prevention of Catheter-Related Colonization and Bloodstream Infections , 1997, Annals of Internal Medicine.

[4]  A. Gabrielli,et al.  Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group. , 1997, Annals of internal medicine.

[5]  M. Pearson Guideline for Prevention of Intravascular-Device–Related Infections , 1996, Infection Control &#x0026; Hospital Epidemiology.

[6]  J. Almaraz,et al.  Departmental role and scope in infection control: use of a template that meets Joint Commission requirements. , 1996, American journal of infection control.

[7]  K. Calligaro Infections associated with indwelling medical devices , 1995 .

[8]  D. Merante,et al.  A prospective study evaluating the effects of extending total parenteral nutrition line changes to 72 hours. , 1995, Journal of Intravenous Nursing.

[9]  D. Maki,et al.  Prospective study of replacing administration sets for intravenous therapy at 48- vs 72-hour intervals. 72 hours is safe and cost-effective. , 1987, JAMA.

[10]  D. Snydman,et al.  Intravenous Tubing Containing Burettes Can Be Safely Changed at 72 Hour Intervals , 1987, Infection Control.

[11]  T. Højbjerg,et al.  Contamination of intravenous infusion systems--the effect of changing administration sets. , 1986, The Journal of hospital infection.

[12]  M. F. Sierra,et al.  The Relationship Between Intravenous Fluid Contamination and the Frequency of Tubing Replacement , 1985, Infection Control.

[13]  E. Jaurrieta,et al.  A randomized trial on the effect of tubing changes on hub contamination and catheter sepsis during parenteral nutrition. , 1985, JPEN. Journal of parenteral and enteral nutrition.

[14]  D. Snydman,et al.  Intravenous tubing with burettes can be safely changed at 48-hour intervals. , 1984, JAMA.

[15]  D. Maki,et al.  Safety of changing intravenous delivery systems at longer than 24-hour intervals. , 1979, Annals of internal medicine.

[16]  A. Buxton,et al.  Contamination of intravenous infusion fluid: effects of changing administration sets. , 1979, Annals of internal medicine.

[17]  D. Maki,et al.  Nationwide epidemic of septicemia caused by contaminated intravenous products. I. Epidemiologic and clinical features. , 1976, The American journal of medicine.