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PubMed2026

Effectiveness of Topical Huzhang Sanhuang with Standard Nursing for Chemotherapy-Induced Phlebitis: Randomized Controlled Study.

Chemotherapy-induced phlebitis (CIP) is a common complication of peripheral intravenous chemotherapy that can cause pain, local inflammation, treatment interruption, and diminished quality of life. This randomized controlled trial evaluated the efficacy and safety of the topical Huzhang Sanhuang (HZSH) formula, combined with standard nursing care, in managing CIP. Ninety-four hospitalized patients with CIP (grade I or higher) were randomly assigned in a 1:1 ratio to receive either topical HZSH formula plus standard nursing care (experimental group, n = 47) or 50% magnesium sulfate wet dressing plus standard nursing care (control group, n = 47) for 14 days. Prespecified outcomes included phlebitis grade, visual analog scale (VAS) pain score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), symptom resolution time, and safety indicators. By Day 14, patients in the experimental group demonstrated significantly greater improvement in phlebitis severity than those in the control group (risk ratio for grade ≥ II, 0.42; 95% confidence interval, 0.20-0.87; P = 0.012). The experimental group also showed significantly larger reductions in VAS pain scores, hs-CRP levels, and IL-6 concentrations (all P < 0.01). Kaplan-Meier analysis further demonstrated faster resolution of multiple local symptoms in the experimental group. Treatment adherence was high in both groups, and no serious adverse events or major safety concerns were observed. These findings indicate that the topical HZSH formula, combined with standard nursing care, is a safe and effective integrative nursing intervention that accelerates clinical recovery, alleviates local symptoms, and reduces the inflammatory burden in patients with chemotherapy-induced phlebitis.

Humans↗

PubMed1975

Filtration and infusion phlebitis: a double-blind prospective clinical study.

The effect of final filtration on the incidence of infusion phlebitis was studied in a prospective, double-blind investigation involving 146 postoperative patients. The incidence of infusion phlebitis was found to be significantly reduced when an inline, 0.45-mum membrane filter was used. The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy. Buffering the infusion fluid or 24-hour change of the administration set did not have any effect on reducing the incidence of phlebitis. Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed. A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids. It is recommended that inline final filters should be a part of routine intravenous therapy.

Adolescent↗

PubMedDate not supplied

[Physical methods in the treatment and prevention of deep phlebitis of the leg].

By the term "physical methods" the author envisages primarily walking, wearing an elastic support, and rest with the legs raised. Physical methods for the prevention and cure of phlebitis were worked out by two French surgeons between the two wars but have been rapidly replaced by coagulant treatment. Now these methods have been reduced, in most cases, simply to a "fight against haemostasis" by means of verbal instructions and with no relation to the original methods : in many cases the methods are not known to the younger generation of physicians because they have not been taught them. Several factors are leading to renewed interest in these methods : on the one hand the undeniable dissatisfaction with anticoagulant therapy, and on the other hand the many experiments that, in the last 15 years, have led to an understanding of the mode of action of the physical methods. These experiments are reviewed in the present article. From the practical point of view, improvements in materials have led to improvements in the range of bandaging techniques. The authors looked back at the original publications, that is to say to the publications of Chalier and of Nard, who described methods, which have been much referred to, that were quite exacting. The different types of bandaging for the prevention and cure of thrombosis are illustrated by numerous pictures. In the curative treatment of phlebitis, there are three essential indications for the use of physical methods : contraindications for anticoagulants, their failure, and the prevention of sequelae. In the prevention of phlebitis, the raising of the legs when seated, a factor in a quasi-experimental stasis, must give way to mobilization - very early and very frequent walking. It is the opinion of specialists in phlebitis, who have used these methods over many years, that the physical methods, which are also physiological, are a valuable complement to biological methods. Their effectiveness is, however, a function of the rigour with which they are applied : --as regards degree : the support must be applied in the correct dosage, as, for example, must heparin and digitalin ; --as regards staff : the patient and his associates must collaborate closely, and nursing staff are indispensable ; --as regards skill : the faith of the physician alone can overcome the doubts or scepticism of others.

Bandages↗

PubMedDate not supplied

[Vasomotor substances and anti-inflammatory agents in the treatment of phlebitis].

Intrafemoral injections of substances known as "vasodilators" are still of the utmost value in the treatment of deep phlebitis as are the anti-inflammatory drugs, particularly in their injectable forms (Butazolidine, Ketazone). The indications are : cases of phlebitis that are just developing ; failure of anticoagulants ; and contraindications to the use of anticoagulants, notably phlebitis during pregnancy. As always in the treatment of phlebitis, therapeutic results are only complete and lasting if an effective support bandage is also applied.

Anti-Inflammatory Agents↗

PubMed2005

[Peripheral venous catheters: incidence of phlebitis and its determining factors].

To determine the rate of phlebitis cases and their risk factors, the authors carried out a prospective follow-up study in an internal medicine unit. 553 catheters pertaining to 266 patients were analyzed. The length of time a catheter was used did not have any significant bearing on the development of phlebitis. The rate of phlebitis cases was more frequent when medication was infused at intermittent intervals. The use of intravenous antibiotics significantly increased the risk of phlebitis when compared to the administration of other types of medication.

Adult↗

PubMed1986

Postinfusion phlebitis associated with a syringe system versus minibags.

The incidence of postinfusion phlebitis was compared in patients receiving i.v. drugs in 50- and 100-mL minibags of 5% dextrose injection or 0.9% sodium chloride injection versus 20- and 50-mL quantities of sterile water for injection or 0.45% sodium chloride injection in plastic syringes used with a venting administration set. Patients 16-75 years of age receiving one or more i.v. drugs and a concurrent maintenance i.v. fluid through a Teflon catheter in a peripheral vein were included. Patients receiving antineoplastic drugs, drugs that require a minimum diluent volume greater than 50 mL, or i.v. heparin sodium in doses of greater than or equal to 500 units/hr were excluded. For the syringe system, the type and amount of diluent were selected to achieve a solution osmolarity of approximately 300 mOsm/L. Patients' i.v. sites were examined every eight hours for 72 hours, and phlebitis was assessed according to predetermined criteria. There were 47 patients in the minibag group and 46 in the syringe group. There were no significant differences between the groups in demographic characteristics, catheter size, duration of infusion, number of doses, number or type of i.v. drugs, or incidence or severity of phlebitis. Administration of i.v. drugs with controlled solution osmolarity via this syringe infusion system was not associated with an incidence of postinfusion phlebitis different from that for i.v. drugs diluted in minibags.

Adolescent↗

PubMedDate not supplied

Relationship between incidence of phlebitis and frequency of changing IV tubing and percutaneous site.

Using stratified random sampling, 130 patients from three hospital units were assigned to three treatment groups to test the relationship between the frequency of changing intravenous (IV) tubing and percutaneous sites and the incidence of phlebitis. Measures of pain, skin temperature, and erythema were collected every 12 hours. Chi-square analysis indicated there were no significant differences in rates of phlebitis whether the tubings were changed every 24 hours or 48 hours. Further, there were no significant differences in the incidence of phlebitis between 48- and 72-hour site change groups. Clinically, subjects in the 24-hour tubing change groups had lower rates of phlebitis. Analysis of the relationship of other factors such as environment, IV medication (heparin, potassium chloride, antibiotics, and corticosteroids), diagnosis, and age showed no statistically significant relationships. It was concluded that more frequent tubing changes are not harmful to subjects and, in fact, may be beneficial.

Adult↗

PubMed1983

[Comparison of side effects of intravenous cephapirin and cephalothin with special reference to the incidence of phlebitis].

The frequency and severity of side effects, above all, phlebitis, associated with an intravenous use of cephapirin (CEPR) or cephalothin (CET) was compared in 69 patients with infections. Two grams of each drug were administered intravenously twice a day with a 21-G vein needle in one of the two arms of the patients. CEPR was administered to 32 patients, and CET to 37 patients respectively. After treatment, the status of the veins was checked, and laboratory findings and other side effects were evaluated daily. Each drug appeared to be equally efficacious in the treatment of infections. The administration of CEPR was associated with a slightly lower rate of phlebitis and other side effects, but the difference between the 2 drugs was not significant (0.05 less than P less than 0.10). Phlebitis was observed in 1 patient (3.1%) of CEPR group and in 3 patients (8.1%) of CET group. Side effects, including phlebitis, were observed in 4 patients (12.5%) of CEPR group and in 12 patients (32.4%) of CET group. In CET group, drug exanthema (3 cases), drug fever (3 cases), and abnormalities in liver function (4 cases) were observed. These findings, together with the results of other reports, suggest that CEPR is a safe and useful drug in the treatment of infection as compared with CET.

Adolescent↗

PubMed1977

Double-blind study to investigate methods to prevent cephalothin-induced phlebitis.

Methods which might be useful in preventing cephalothin-induced phlebitis following intravenous administration of the buffered drug were investigated. One hundred and twenty adult orthopedic patients were assigned randomly to either a control group or one of five treatment groups. The treatment regimens studied were: addition of hydrocortisone phosphate 10 mg to each liter of intravenous fluid; addition of heparin 1,000 units to each liter of intravenous fluid; addition of heparin 500 units and hydrocortisone phosphate 1 mg to each liter of intravenous fluid; addition of heparin 1,000 units and hydrocortisone phosphate 10 mg to each liter of intravenous fluid; and filtration of intravenous solutions through a 0.22-mum inline filter. All patients in the study received intravenous buffered cephalothin at a dosage of 1 g every six hours for a minimum of 48 hours. Phlebitis was assessed every 12 hours according to predetermined criteria. Significant differences were found in the incidence of phlebitis at 48 hours between the control group and the last three study groups (see above). It is concluded that postinfusion phlebitis following cephalothin administration can be reduced by the concomitant addition of heparin and hydrocortisone to the intravenous solution or by the use of an inline 0.22-mum final filter.

Adolescent↗

PubMed1976

Phlebitis associated with the intravenous use of cephalothin and cephapirin.

The frequency and severity of phlebitis associated with cephalothin and cephapirin was compared in a double-blind study in 82 surgical patients with 149 different infusion sites. After treatment with the coded drug products, the status of each patient's veins was evaluated daily by i.v. therapists. Cephapirin was associated with a slightly lower rate of phlebitis, but the difference was not significant. For both drugs, the duration of therapy did not appear to have an effect on the rate of phlebitis. Scalp vein needles were associated with a lower rate of phlebitis than plastic catheters, but the difference was not significant.

Cephalosporins↗

PubMed1983

Recurrence of intravenous-diazepam-induced phlebitis from oral diazepam.

A patient who developed phlebitis from the intravenous administration of diazepam is described. This episode resolved in two days after treatment with moist heat packs. Three days after complete resolution, the phlebitis recurred approximately eight hours after a single oral dose of diazepam. This recurrence of phlebitis resolved slowly over seven days, with warm soaking and aspirin therapy. Oral diazepam may have exacerbated the initial phlebitis by interfering with a subclinical healing process.

Administration, Oral↗

PubMed1983

Prevention of lidocaine-infusion phlebitis by heparin and hydrocortisone.

Previous reports have suggested that infusions of lidocaine (lignocaine) cause a high incidence of phlebitis. We investigated the possibility of reducing this high incidence by the addition of small amounts of heparin or hydrocortisone (or both) to the infusate of lidocaine. One hundred patients with acute myocardial infarction who were to receive a 48-hour prophylactic infusion of lidocaine (2.25 mg/min) were randomized to have one of the following added to their infusate in double-blind fashion: (1) placebo; (2) heparin (4,000 units/24 hr); (3) hydrocortisone (20 mg/24 hr); or (4) heparin and hydrocortisone. After 48 hours the incidence of phlebitis was 94 percent in the control group but only 41 percent in the group receiving heparin and hydrocortisone (p less than 0.005). Had the infusion been stopped after 24 hours, the incidence of phlebitis would have been 56 percent in the group receiving placebo, but only 19 percent in the drug-treated groups (p less than 0.01). We conclude that infusion of lidocaine causes a high incidence of phlebitis which can be markedly reduced by adding heparin or hydrocortisone (or both) to the infusate and limiting the duration of the infusion in a given vein to 24 hours.

Heparin↗

PubMedDate not supplied

[Painful manifestations of the sequelae of phlebitis].

Pain may be absent from the various manifestations making up a post-phlebitis syndrome but when it is present it varies considerably from one patient to another. Thus the very common feeling of heaviness, generally not painful, may be perceived as being painful by certain patients either because of the particular severity of the feeling or because of a low pain threshold in certain cases. Since no method for the objective measurement of pain exists, the assessment of this symptom and of its severity remains highly subjective, most often based upon statements by the patients. However, in practice a distinction can be drawn between the following: Pain related to venous stasis: a simple feeling of heaviness most often but which, in certain patients, may take on a painful connotation. Among such "stasis" pains, particular mention must be made of venous intermittent claudication, a progressive feeling of calf tension during walking which becomes increasingly painful and finally forces the sufferer to stop. This symptom is generally linked to the obstruction of a large collecting vein. Pain accompanying a leg ulcer usually results from secondary infection. Mention may be made of the role of inflammatory lesions developing around the trophic problem and which may encompass nerves, in particular the internal saphenous nerve. Although classical, causalgia type pain is certainly rarer. Demyelinisation of peripheral nerves has been suggested as being at its origin. Once again, the role of inflammatory processes linked to secondary infection appears to be notable. The treatment of pain in a post-phlebitis patient must take the greatest possible account of the pathophysiology of the post-phlebitis syndrome responsible: disinfection of a leg ulcer, treatment of venous stasis by elastic support, or by surgery or sclerosing injections. Sympathectomy has been suggested in causalgia type pain. In fact, this operation has scarcely any indications in post-phlebitis syndrome.

Humans↗

PubMedDate not supplied

[Phlebitis in a child due to a femoral exostosis. Apropos of 1 case].

The author describes the case of a child aged 11 spontaneously presenting a right surral phlebitis. The positive diagnosis was made immediately, with the aid of Functional vascular Investigation, that is venous Doppler and venous occlusion rheoplethysmography. A standard X-ray showed the existence of a right posterior femoral exostosis which looked as though it had been a causal factor in this phlebitis. However, the aetiological proof of this could not be given until seven months later, using phlebography. A survey of the existing literature does not reveal a comparable spontaneous case, without associated causal traumatism. For one thing, femoral osteogenic exostoses do not, despite their frequent occurrence, provoke more than a minimum of vascular complications, affecting the femoral or popliteal veins in particular. For another, spontaneous phlebitis in children are extremely rare and when they do occur it is as a result of haemopathies or collagenoses. Functional Vascular Investigation, now common practice in adults, made it possible to follow very precisely the development of the phlebitis in this child, and to check up on its sequelae. The great correlation between these functional investigations and clinical explorations and phlebography confirms their merit. They could be applied more systematically in infantile pathology.

Bandages↗

PubMedDate not supplied

Treatment of infusion-related phlebitis: review and nursing protocol.

Infusion-related phlebitis is a frequently occurring, but often preventable complication associated with intravenous therapy. Early detection with prompt, consistent nursing intervention decreases the occurrence and severity of cannula-related phlebitis. This article reviews the clinical aspects of phlebitis and describes a comprehensive approach for the treatment of infusion-related phlebitis.

Clinical Protocols↗

PubMed1994

Subcutaneous, catheter-related inflammation in a rabbit model correlates with peripheral vein phlebitis in human volunteers.

In the development of a polyurethane vascular catheter with anti-infective properties, it became desirable to develop a measure of tissue inflammation. This was investigated in a rabbit model by implanting uncoated catheters and catheters coated with heparin (HEP), chlorhexidine (CH), or CH/HEP in the subcutaneous space with or without 10(4) Staphylococcus aureus. At intervals of 2, 4, and 7 days after implantation, animals were sacrificed; tissue blocks containing catheters were removed and preserved with formaldehyde; and sections were stained with hematoxylin and eosin. Using a histologic index, 240 sections (10 for each experimental condition) were evaluated by two investigators blinded to experimental conditions. Uncoated catheters or catheters coated with CH alone had a lower histologic index (less inflammation) than catheters coated with HEP alone or CH/HEP (P < .05). When catheters were inoculated with S. aureus, those coated with CH, with or without HEP, had a lower histologic index than uncoated catheters (P < .05). Next, 30 volunteers had a control catheter inserted in a vein in one forearm and a catheter coated with either CH alone or CH/HEP in a vein in the other forearm. After 96 h of observation there was a greater risk of phlebitis associated with CH/HEP catheters than control catheters (P < .05), and no difference in the risk of phlebitis between CH catheters and control catheters (P = 0.43). Thus, the amount of inflammation around the catheter in the subcutaneous space of rabbit correlated with the risk of peripheral vein phlebitis.

Adult↗

PubMed2003

Pichia ohmeri fungemia associated with phlebitis: successful treatment with amphotericin B.

We report a case of fungemia caused by the yeast-form fungus Pichia ohmeriin a 59-year-old hospitalized patient. P. ohmeri was found in all of the patient's blood cultures collected on days 52, 57, 59, and 64 of his hospital stay. Intermittent fever developed on the 52nd hospital day and persisted for about 10 days. The patient had previously received intensive antimicrobial therapy for a ventriculoperitoneal shunt infection and subsequent nosocomial pneumonia. Although a central venous catheter was not used in the patient, he suffered from tender swelling of the right leg due to peripheral phlebitis at the site of insertion of a peripheral venous catheter (which had already been removed at the onset of fever), the same site from which P. ohmeri was isolated. The fungemia and phlebitis cleared following 14-day amphotericin B therapy. This case shows that P. ohmeri can be a nosocomial bloodstream pathogen associated with phlebitis.

Amphotericin B↗

PubMed1988

Bacterial colonization and phlebitis-associated risk with transparent polyurethane film for peripheral intravenous site dressings.

Previous studies of various brands of polyurethane dressings have noted differences in the rates of catheter colonization. We compared Bioclusive transparent polyurethane (TP) dressing with a cotton gauze (CG) dressing on peripheral intravenous (IV) access sites for the incidence of phlebitis, catheter tip colonization, skin colonization, and catheter-related bacteremia. The study, involving 598 ward patients, was case controlled, prospective, and randomized for a period of 4 months. Each patient was entered into the study only once, and all dressings were applied by a member of the IV therapy team. No significant difference was seen for phlebitis rate (TP: 9.8% vs. CG: 7.6%) or catheter tip colonization, defined as greater than 15 colony forming units (CFU) (5.7% vs. 4.4%) by a semiquantitative technique. Cultures of specimens from the skin and catheter tips of the majority of patients (91%) showed no growth. An association was found between those patients with greater than 15 CFU isolated from catheter tips and those with phlebitis (p = 0.022). No documented catheter-related bacteremia occurred in either study group.

Adult↗