Associação entre flebite e retirada de cateteres intravenosos periféricos

Abstract

RESUMO:Estudo de coorte prospectivo, com objetivo de verificar a incidência de flebite em pacientes com cateter intravenoso periférico e identificar possíveis associações dessa complicação com variáveis relativas a estes cateteres. Foram avaliados 76 pacientes adultos internados em enfermaria de um hospital universitário, utilizando-se de uma ficha contendo variáveis relativas aos pacientes, ao cateter intravenoso periférico e à terapia farmacológica. A flebite foi avaliada segundo classificação proposta pela Infusion Nurses Society. Utilizou-se estatística descritiva e inferencial. Observou-se incidência de 25,8% de flebite, das quais 40% apresentaram manifestações clínicas de dor, com eritema e ou edema. Dentre os pacientes com flebite, 60% desenvolveram um episódio da complicação, e o tempo de permanência médio dos cateteres intravenosos periféricos com flebite foi de 3,10 dias. Constatou-se associação da flebite à retirada do cateter intravenoso periférico por ocorrência adversa (p<0,001). São necessárias ações educativas e capacitação da equipe de enfermagem para o manejo da terapia intravenosa, principalmente no que tange à detecção precoce da flebite. RElaTION bETWEEN pHlEbITIS aNd pERIpHERal INTRavENOUSCaTHETER REMOval abSTRaCT: The objective of this prospective study is to verify the incidence of phlebitis among patients with peripheral intravenous catheters and to identify possible relations between this complication and catheter-related variables. Seventy-six adult patients hospitalized in a Brazilian university hospital were evaluated, using charts with patient-related variables, peripheral intravenous catheters, and pharmacological therapy. Phlebitis was evaluated based on Infusion Nurses Society proposed classification. Inferential and descriptive statistics have been used. We observed 25.8% incidence of phlebitis, from which 40% presented pain occurrences, with erythema and edema. Among patients with phlebitis, 60% developed a complication episode, and the average period of permanence of peripheral intravenous catheters with phlebitis was 3.10 days. We observed phlebitis associations to adverse occurrences during the removal of peripheral intravenous catheters (p<0.001). Educational actions and professional training for nursing personnel are necessary for dealing with intravenous therapy, mainly on what is related to early detection of phlebitis.dESCRIpTORS: Intravenous infusions. Phlebitis. Nursing. Nursing care. Peripheral catheterization. RElaCIÓN ENTRE la FlEbITIS Y la RETIRada dE CaTéTERES INTRavENOSOS pERIFéRICOSRESUMEN: Se trata de un estudio prospectivo para determinar la incidencia de flebitis en pacientes con catéter intravenoso periférico e identificar posibles asociaciones de esta complicación con las variables relacionadas con el catéter intravenoso periférico. Se evaluaron setenta y seis pacientes adultos hospitalizados en el sector de enfermería de un hospital universitario, mediante un formulario que contiene las variables relacionadas con los pacientes, el catéter intravenoso per...

Incidência de flebite e flebite pós-infusional em adultos hospitalizados

“…In Brazil, only one study found lower values, with a density incidence of 1.25% for phlebitis during PIC and 1.38% for post-infusion phlebitis (13) . When data analysis is based on incidence, the results (7.15% for phlebitis during PIC) are lower than those of other studies, which recorded incidences of 8.5% (14) , 10.5% (4) , 25.8% (7) , and 59.1% (15) , and higher than a study that recorded an incidence of 4% (16) . With the exception of the latter record, the values found are above the recommendation of the Infusion Nurses Society that establishes that the acceptable rate of phlebitis for a given population is up to 5% (2) .…”

“…A study shows that there is no indication of the ideal anatomic region to reduce the risk of phlebitis. Most of the punctures were performed with a 22 G PIC (51.2%), which may have reduced the occurrence of phlebitis, as pointed out in another study (4) .…”

“…A study conducted at the Clinical Hospital of the Universidade Estadual de Campinas (4) found that 25% of the cases of phlebitis evolved to Grade IV. In this study, only 0.7%, of the cases of phlebitis evolved to Grade IV.…”

“…In Brazilian studies, the incidence of phlebitis was 10.5% (7) , 25.8% (4) , 31.6% (8) , and 55.6% (9) . We did not find any Brazilian or international publication reporting the incidence of post-infusion phlebitis.…”

“…In the hospital setting, phlebitis is one of the most frequent complications and considered one of the main faults of infusion. Once phlebitis is identified, intravenous treatment must be interrupted since it can compromise the patients' health and even extend the hospital stay (4) .…”