The Incidence of Phlebitis in Patients Receiving Amiodarone Administration

Abstract

OBJECTIVE: To determine the incidence of phlebitis after amiodarone administration in Bangkok Hospital Rayong, and to study the factors affecting phlebitis in patients receiving intravenous amiodarone.MATERIALS AND METHODS: The retrospective study was conducted by reviewing patient medical records from all patients who received intravenous amiodarone during January 2011- December 2014. Concentration, type of dilute solution, duration of amiodarone therapy, peripheral intravenous size of catheter, age and underlying disease were examined. Descriptive statistics were used to analyze concentration, type of solution, duration, peripheral intravenous size of catheter, age and underlying disease. Chi - square test was used to analyze the factors affecting the phlebitis.RESULTS: In the sample of 127 patients, 16 patients had phlebitis and the incidence of phlebitis was 12.6%. Phlebitis occurred in 14.4% of patients given a concentration ≤ 2 mg/ml and 6.7% concentration more than 2 mg/ml. Depending on the size of the catheter, it was found that 32.1% of phlebitis occurred in patients who received a catheter 22-gauge (G) size and larger whereas none of the patients who received a catheter 24-G size presented with phlebitis. Regarding the duration of amiodarone administration, 35% of patients received amiodarone administered >24-48 hours and 50% of these received medication in > 48 hours while in those who received medication in ≤ 24 hours, the occurrence of phlebitis was only 7.6%. The duration of amiodarone administration was significantly associated with phlebitis.CONCLUSION:The incidence of phlebitis occurrence by amiodarone intravenous administration at peripheral entry mainly radial vein and few via cubital vein was studied, and we found that by using catheter 24-G, phlebitis will not occur, regardless of the concentration, duration and dilution (mixed with DW or NSS). The explanation for this is the faster speed of administration in catheter 24-G than the larger size of catheter resulting in the amiodarone not aggregating and combining with platelets, white blood cells and red blood cells that cause phlebitis.