Cyclic infusion is effective in reducing phlebitis caused by peripheral parenteral nutrition solutions: An experimental study in rabbits

SummaryBackground & aimsWe have previously shown that decreasing the infusion duration (increasing the infusion rate) reduces phlebitis caused by hypertonic solutions. This study aimed to confirm that a cyclic infusion (intermittent infusions) is a preferable administration method to reduce phlebitis in peripheral parenteral nutrition.MethodsIn the continuous group, a 3% amino acid/7.5% glucose solution with electrolytes (856 mOsm/kg, pH6.6) was infused once into a rabbit ear vein for 24 h at 5 mL/kg/h (120 mL/kg/day). In the cyclic group, the same solution was infused for 8 h at 15 mL/kg/h (120 mL/kg/day) for 3 consecutive days, in which these catheters were inserted at the same site. These infused veins were examined histopathologically, and these grades of phlebitic changes were analyzed using the Wilcoxon rank sum test.ResultsIn the continuous group, single 24-h infusion caused phlebitic changes in all rabbits. Even after administering for 3 days in the cyclic group, the 8-h infusion per day scarcely caused changes. Significant differences were observed in these changes such as loss of venous endothelial cells and perivascular edema between the continuous group and the cyclic group.ConclusionsThese results strongly suggest that a cyclic infusion is a preferable administration method to reduce phlebitis in peripheral parenteral nutrition using standard short catheters.