Removing intravascular lines at 72 hours allows need for antibiotics to be reassessed

BMJ 1998;316:1825 ( 13 June )

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Removing intravascular lines at 72 hours allows need for antibiotics to be reassessed

The first 150 words of the full text of this article appear below.

EDITOR $---$ Randolph et al's meta-analysis suggests that continuous infusions of low dose heparin prolong the patency of arterialand venous peripheral catheters.¹ This is encouraging for both patients with needle phobia and junior doctors. The authors donot, however, emphasise the risks of invasive vascular devices,particularly the infective risks.

Although some studies disagree, it is widely accepted that rates of phlebitis and infection (both local and systemic) associatedwith intravascular lines are related to the duration of insertion.²The American Hospital Infection Control Practices Advisory Committeestrongly recommends replacing peripheral venous catheters in adultsevery 48-72 hours.

The problem of hospital acquired infection related to intravascular lines should not be underestimated. A recent survey bythe Public Health Laboratory Service found that invasive devicesconstituted by far the most important risk factor for hospitalacquired infection.³ From our own unpublished figures we foundthat 37% of cases of hospital . . . [Full text of this article]

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Benefit of heparin in peripheral venous and arterial catheters: systematic review and meta-analysis of randomised controlled trials: Adrienne G Randolph, Deborah J Cook, Calle A Gonzales, and Maureen Andrew
BMJ 1998 316: 969-975. [Abstract] [Full Text] [PDF]