Intravenous cannulation is a cornerstone of today's medical practice. Maintaining a single indwelling intravenous (IV)
cannula for long duration is limited by the development of superficial
thrombophlebitis (ST). It is a self limiting
inflammation and
thrombosis of superficial veins. ST presents with
fever,
pain,
erythema, tenderness and cord like swelling. The incidence of ST is high and usually occurs within 72h of IV
cannula insertion. The current standard medical
therapy for ST is topical
heparin application for 7 days.
Heparin acts by preventing coagulation rather than lysing a formed clot. So, if topical
heparin is started prophylactically even before ST sets in, i.e. from day 1 of IV
cannula insertion it can prevent or postpone ST more effectively. It increases the indwelling time of a single IV
cannula and can be very useful in high risk groups requiring IV cannulation like patients receiving
cancer chemotherapy, ICU patients and infants. It decreases the need for recurrent cannulations and associated morbidity thereby improving patient compliance. It also prevents extended
hospital stay due to ST and related complications. High incidence of ST justifies the use of prophylactic topical
heparin with all IV cannulations. Prophylaxis will be better than treatment in managing patients with IV cannulas.