SAFETY OF CHANGING INTRAVENOUS DELIVERY SYSTEMS AT LONGER THAN 24-HOUR INTERVALS

Routinely changing the i.v. delivery system (fluid containers and administration set) every 24 h is widely practiced in American hospitals to reduce the risk of [human] septicemia caused by contaminated infusate. A prospective clinical study was done to ascertain whether changing at longer intervals could be justified. At the conclusion of infusion therapy through 1 system, the cannula and an aliquot of remaining fluid were cultured quantitatively. Of 790 infusions, contaminated infusate was detected in 1 (0.39%) of 258 discontinued and sampled after 1-24 h of continuous use, 3 (0.84%) of 359 after 25-48 h and 1 (0.58%) of 173 after 49-71 h; none of these 5 contaminated systems produced septicemia. Five cannula-related septicemias were identified during the study, none associated with concordant contamination of infusate. Routinely replacing the delivery system every 48 h seems justified and could result in considerable savings to hospitals. Infection of the cannula wound and contamination of infusate seem unrelated.