Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial

We read with interest the article by Webster et al. concerning the
need for routine replacement of peripheral intravenous catheters. As busy
clinicians we have often been frustrated by the need to recannulate
patients whose peripheral access was removed when apparently working well
due to infection control policies. Therefore we welcome any attempt to
uncover a poor scientific basis to this policy.

Despite this we feel that this article cannot be given merit. The
methodology was suspect, with poor compliance to study protocol and a high
degree of patient exclusion. The data presentation is confusing with the
most clear results appearing to be that only 26% of cannulae stayed in
long enough to meet the 72hr cut off for replacement and that phlebitis
and infiltration occurred in > 3rd of patients in both groups. Finally
the conclusions are nonsensical and at odds with the author’s discussion.

This paper goes to great length to criticize the original Scarborough
data, however its own findings seem only to support that papers conclusion
that leaving peripheral cannulae in-situ greater than 48hrs leads to high
levels of failure and phlebitis.

1: Randomised clinical trial of elective re-siting of intravenous
cannulae. Barker P, Anderson AD, MacFie J. Ann R Coll Surg Engl. 2004
Jul;86(4):281-3.

Competing interests:
None declared