Can a slow continuous intravenous therapy prolong the life of peripheral intravenous cannulae in the clinical setting?
There is lack of current research evidence to suggest that continuous infusion also known as to ‘keep vein open’ to a peripheral intravenous cannula will prolong the life expectancy of a cannula. There is much discussion and debate among health care staff over the ability of a continuous infusion to prolong the life of a cannula. Many patients are often prescribed intravenous therapy at a slow rate in hospital setting not for nutritional needs, but for the purpose of maintaining and prolonging the life of the cannula. However, continuous intravenous therapy has been believed to lead to early dislodgment of cannula’s due to patient’s; mobilising, dressing and showering whilst are attached to intravenous therapy via a cannula, resulting increased number of re-sites.
Literature on the effects of slow intravenous infusion to peripheral intravenous cannulae in prolonging the life time of the cannulae is limited due to lack of research and differing outcomes. Schulman (2003) discusses the lack of randomized clinical trials that compare continuous infusion with bolus flushes and the limitations of studies previously done due to the sample sizing and data analysis. Furthermore, no specific definition of an infusion rate has been scientifically proven to ‘keep vein open’, as flow rates are affected by many variables such as fluid viscosity, position of cannulae and length (Hawkins et al. 2001). Cannulation is a necessary part of medical treatment, but is often a painful procedure for patients. Numerous re-sites are stressful and upsetting for patients and can potentially cause difficulty in the future for venous access due to repeated damage to the vein (Webster et al. 2007). If research studies can assess various methods to cannula care and management using continuous infusion or intermittent flushes, then perhaps discomfort and stress can be reduced if frequent re-sites can be prevented by improved cannula care. A similar study by Flint and Davies (2008) examined the use of intermittent flushes to peripheral intravenous cannulae in neonates only requiring antibiotic administration compared to the use of continuous infusion in prolonging the life of cannulae in situ, this study showed a shorter life time of cannulae in the continuous infusion group compared to the intermittent flush group, with median life time of 36 hours in the continuous infusion group and 36.5 hours in the intermittent flushes group. A reduction in cost and mother to neonate interferences was noted in the intermittent flush group (Flint & Davies, 2008). However, a study conducted by Lundgren, Jorfeldt & Ek (1998) observed the care and handling on peripheral intravascular cannulae in a clinical setting had differing outcomes. Results from the study showed 17 out of 30 (56%) participants being treated with an intravascular infusion developed thromboplebitis. Whilst 20 out of 50 (67%) subjects with an intravenous cannula not connected to a fluid infusion developed thrombophlebitis. The management of continuous intravenous infusion should be researched further due to the lack of current research and evidenced based practice in relation to prolo...