Evidence map›Paper›PMID 20831782›Full record

Trial reportBMC medicine2010

Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial.

Claire M Rickard, Damhnat McCann, Jane Munnings, Matthew R McGrail

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04046770 (Innovative Device for Intravenous Administration), which is not on this map. Cited by 30 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04046770 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Innovative Device for Intravenous Administration

TypeinterventionalSponsorEscola Superior de Enfermagem de CoimbraRan2020 to 2020Enrolled146ConditionsSafety Issues, Medical DeviceArmsDrug administration and Flushing procedure using Double-Chamber Syringe, Drug administration and Flushing procedure using Classic Syringe
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  14. Preventing healthcare-associated MRSA bacteremia: getting to the root of the problem.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023
    Article
  15. Observational
  16. Observational
  17. Local complications of intravenous access - an often underestimated entity.Journal of family medicine and primary care · 2020
    Article
  18. Article
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  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Claire M RickardResearch Centre for Clinical and Community Practice Innovation, Griffith University, 170 Kessels Rd, Nathan Qld 4111, Australia. c.rickard@griffith.edu.au
Damhnat McCann
Jane Munnings
Matthew R McGrail

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripheral intravenous device (IVD) complications were traditionally thought to be reduced by limiting dwell time. Current recommendations are to resite IVDs by 96 hours with the exception of children and patients with poor veins. Recent evidence suggests routine resite is unnecessary, at least if devices are inserted by a specialised IV team. The aim of this study was to compare the impact of peripheral IVD 'routine resite' with 'removal on clinical indication' on IVD complications in a general hospital without an IV team.

methodsA randomised, controlled trial was conducted in a regional teaching hospital. After ethics approval, 362 patients (603 IVDs) were randomised to have IVDs replaced on clinical indication (185 patients) or routine change every 3 days (177 patients). IVDs were inserted and managed by the general hospital medical and nursing staff; there was no IV team. The primary endpoint was a composite of IVD complications: phlebitis, infiltration, occlusion, accidental removal, local infection, and device-related bloodstream infection.

resultsIVD complication rates were 68 per 1,000 IVD days (clinically indicated) and 66 per 1,000 IVD days (routine replacement) (P = 0.86; HR 1.03; 95% CI, 0.74-1.43). Time to first complication per patient did not differ between groups (KM with log rank, P = 0.53). There were no local infections or IVD-related bloodstream infections in either group. IV therapy duration did not differ between groups (P = 0.22), but more (P = 0.004) IVDs were placed per patient in the routine replacement (mean, 1.8) than the clinical indication group (mean, 1.5), with significantly higher hospital costs per patient (P < 0.001).

conclusionsResite on clinical indication would allow one in two patients to have a single cannula per course of IV treatment, as opposed to one in five patients managed with routine resite; overall complication rates appear similar. Clinically indicated resite would achieve savings in equipment, staff time and patient discomfort. There is growing evidence to support the extended use of peripheral IVDs with removal only on clinical indication. REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ANZCTR) Number ACTRN12608000421336.

Indexed as

AdultAgedAged, 80 and overCatheterization, PeripheralCatheter-Related InfectionsDevice RemovalEquipment FailureFemaleHumansInfusions, IntravenousMaleMiddle AgedPhlebitisPractice Guidelines as TopicTime Factors

Identifiers

PMID20831782
PMCPMC2944158

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.