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Phlebitis and IV Infusion Sets

I am working on implementing a guideline for chainging IV infusion sets and have run into something that confuses me.  In the INS Infusion Therapy in Clinical Practice book, you know, our big blue bible, on page 398 states "...that continuous peripheral and central primary sets and secondary administration sets should be changed every 72 hours.  However, failure to maintain an ongoing phlebitis rate of 5% or less, or any increased rate of catheter-related bacteremia, requires a return to 48-hour administration set change." 

Here is my question.  What has phlebitis got to do with the length of time that tubing has hung?  I thought the reason that we changed tubing periodically was to avoid catheter related blood stream infrections.  What is the link with phlebitis?

Microorganisms are one of
Microorganisms are one of the 3 cause of phlebitis- mechanical, chemical, and infectious. We have taught this for many years, however the 2006 INS SOP removed this statement about linking the timing of set changes to the rate of phlebitis because of the age of this concept. The current document states to change primary and secondary continuous administration sets "no more frequently than 72 hours" which is the same wording as the CDC guidelines. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

 Thanks Lynn, I was hoping

 Thanks Lynn, I was hoping you would respond.  I guess I just thought that if you were infusing bacteria in levels that caused a phlebitis, that phlebitis would be the least of your problems.  I apparently underestimated the ability of the endothelium to mount an inflammatory response.


Jerry Bartholomew RN, BSN, CRNI

VA Medical Center, Spokane, WA

Jerry Bartholomew RN, MSN, CRNI

VA Medical Center, Spokane, WA

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