（IV） Intravenous therapy is one of the most commonly performed procedures in hospitalized patients yet phlebitis affects 27% to 70% of all patients receiving IV therapy. The incidence of phlebitis has proved to be a...（IV） Intravenous therapy is one of the most commonly performed procedures in hospitalized patients yet phlebitis affects 27% to 70% of all patients receiving IV therapy. The incidence of phlebitis has proved to be a menace in effective care of surgical patients, delaying their recovery and increasing duration of hospital stay and cost. The recommendations for reducing its incidence and severity have been varied and of questionable efficacy. The current study was undertaken to evaluate whether elective change of IV cannula at fixed intervals can have any impact on incidence or severity of phlebitis in surgical patients. All patients admitted to the Department of Surgery, SMIMS undergoing IV cannula insertion, fulfilling the selection criteria and willing to participate in the study, were segregated into two random groups prospectively： Group A wherein cannula was changed electively after 24 hours into a fresh vein preferably on the other upper limb and Group B wherein IV caunula was changed only on development of phlebitis or leak i.e. need-based change. The material/brand and protocol for insertion of IV cannula were standardised for all patients, including skin preparation, insertion, fixation and removal. After carmulation, assessment was made after 6 hours, 12 hours and every 24 hours thereafter at all venepuncture sites. VIP and VAS scales were used to record phlebitis and pain respectively. Upon analysis, though there was a lower VIP score in group A compared to group B （0.89 vs. 1.32）, this difference was not statistically significant （p-value = 0.277）. Furthermore, the differences in pain, as assessed by VAS, at the site of puncture and along the vein were statistically insignificant （p-value 〉 0.05）. Our results are in contradiction to few other studies which recommend a policy of routine change of carmula. Further we advocate a close and thorough monitoring of the venepuncture site and the length of vein immediately distal to the puncture site, as well as a meticulous standardized protocol for IV access.展开更多
Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phle...Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phlebitis.This study was designed to investigate effects of anisodamine on the expressions of vascular endothelial growth factor （VEGF） and intercellular adhesion molecule 1 （ICAM-1） in a rabbit model of infusion phlebitis and to analyze the mechanisms of anisodamine effect on the prevention and treatment of experimental infusion phlebitis.Methods Twenty-four specific pathogen-free male Japanese white rabbits were randomly assigned to the control group,the model group,the magnesium sulfate group and the anisodamine group.The rabbit model of infusion phlebitis,induced by intravenous administration,was established and expressions of VEGF and ICAM-1 were determined and contrasted with the control group treated with normal saline.We evaluated expression by histopathology,immunohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting assay.Results Pathohistological changes of the model group were observed,such as loss of venous endothelial cells,inflammatory cell infiltration,edema and thrombus.The magnesium sulfate group and the anisodamine group showed significant protective effects on vascular congestion,inflammatory cell infiltration,proliferation,swelling of endothelium and perivascular hemorrhage.The model group showed the highest expressions of VEGF and ICAM-1 of the four groups （P〈0.01）.On the contrary,anisodamine alleviated the inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1 compared with the model group （P 〈0.01）.There was no significant difference in the expressions of VEGF and ICAM-1 between the magnesium sulfate group and the anisodamine group （P 〉0.05）.Conclusion Anisodamine alleviates inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1,and shows significant protective effects展开更多
文摘（IV） Intravenous therapy is one of the most commonly performed procedures in hospitalized patients yet phlebitis affects 27% to 70% of all patients receiving IV therapy. The incidence of phlebitis has proved to be a menace in effective care of surgical patients, delaying their recovery and increasing duration of hospital stay and cost. The recommendations for reducing its incidence and severity have been varied and of questionable efficacy. The current study was undertaken to evaluate whether elective change of IV cannula at fixed intervals can have any impact on incidence or severity of phlebitis in surgical patients. All patients admitted to the Department of Surgery, SMIMS undergoing IV cannula insertion, fulfilling the selection criteria and willing to participate in the study, were segregated into two random groups prospectively： Group A wherein cannula was changed electively after 24 hours into a fresh vein preferably on the other upper limb and Group B wherein IV caunula was changed only on development of phlebitis or leak i.e. need-based change. The material/brand and protocol for insertion of IV cannula were standardised for all patients, including skin preparation, insertion, fixation and removal. After carmulation, assessment was made after 6 hours, 12 hours and every 24 hours thereafter at all venepuncture sites. VIP and VAS scales were used to record phlebitis and pain respectively. Upon analysis, though there was a lower VIP score in group A compared to group B （0.89 vs. 1.32）, this difference was not statistically significant （p-value = 0.277）. Furthermore, the differences in pain, as assessed by VAS, at the site of puncture and along the vein were statistically insignificant （p-value 〉 0.05）. Our results are in contradiction to few other studies which recommend a policy of routine change of carmula. Further we advocate a close and thorough monitoring of the venepuncture site and the length of vein immediately distal to the puncture site, as well as a meticulous standardized protocol for IV access.
文摘Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phlebitis.This study was designed to investigate effects of anisodamine on the expressions of vascular endothelial growth factor （VEGF） and intercellular adhesion molecule 1 （ICAM-1） in a rabbit model of infusion phlebitis and to analyze the mechanisms of anisodamine effect on the prevention and treatment of experimental infusion phlebitis.Methods Twenty-four specific pathogen-free male Japanese white rabbits were randomly assigned to the control group,the model group,the magnesium sulfate group and the anisodamine group.The rabbit model of infusion phlebitis,induced by intravenous administration,was established and expressions of VEGF and ICAM-1 were determined and contrasted with the control group treated with normal saline.We evaluated expression by histopathology,immunohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting assay.Results Pathohistological changes of the model group were observed,such as loss of venous endothelial cells,inflammatory cell infiltration,edema and thrombus.The magnesium sulfate group and the anisodamine group showed significant protective effects on vascular congestion,inflammatory cell infiltration,proliferation,swelling of endothelium and perivascular hemorrhage.The model group showed the highest expressions of VEGF and ICAM-1 of the four groups （P〈0.01）.On the contrary,anisodamine alleviated the inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1 compared with the model group （P 〈0.01）.There was no significant difference in the expressions of VEGF and ICAM-1 between the magnesium sulfate group and the anisodamine group （P 〉0.05）.Conclusion Anisodamine alleviates inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1,and shows significant protective effects
