In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

Abstract

Background: In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration. Methods: We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access. Results: In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay. Conclusion: In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

Spallation and particles infusion into the extracorporeal circuit during CRRT: a preventable phenomenon

“…Post-mortem studies have demonstrated the presence of plastic and glass particles in the vessels and lungs of critically ill patients, resulting in mechanical blockage of the microcirculation, local inflammation, and tissue granuloma 2 , 3 . Several studies have demonstrated the capability of intravenously infused particles to induce endothelial damage, inflammation, and immune system activation 4 , 5 . Particle retention positively affects surgical and critically ill patients, especially when treated with high amounts of intravenous fluids and drugs.…”

“…In-line filters are disposable products placed inside the intravenous line to retain particles and prevent unintentional administration to the patient through the vascular access device. Villa et al demonstrated that in-line filters significantly reduce endothelial damage in surgical patients 4 , 5 . Furthermore, Sasse et al observed a significant reduction in the development of systemic inflammatory disorders and multiple organ dysfunction in a cohort of intensive care unit (ICU) patients when in-line filtration was applied to prevent the infusion of intravenous particles during the ICU stay 1 .…”