Complications of intravenous
therapy with steel needles and small-bore
Teflon catheters were compared in a randomized study of 954
cannula insertions. Cannulas were inserted and cared for by an intravenous team following a standard protocol. There were no cases of
cannula-related
septicemia and only one case of local
infection, a
cellulitis in the group in which
Teflon catheters were used. There was a low incidence of positive semiquantitative
cannula cultures in both treatment groups (steel needles 1.5 percent,
Teflon catheters 1.4 percent). The risk of
phlebitis was significantly greater with
Teflon catheters (18.8 percent with
Teflon catheters, 8.8 percent with steel needles, adjusted odds ratio 1.87). Steel needles were significantly associated with infiltration (17.9 percent with
Teflon catheters, 40.1 percent with steel needles, adjusted odds ratio 0.39). The over-all rate of complications was significantly greater for the group in which steel needles were used (53.8 versus 64.0 percent, adjusted odds ratio 0.72), principally due to the increased risk of infiltration with steel needles. Analysis of the per day risk of infiltration and
phlebitis revealed that these relationships were present for each day the cannulas remained in place. We conclude (1) that steel needles and small-bore
Teflon catheters can both be used with low risk of
infection and (2) that
Teflon catheters more frequently cause
phlebitis, whereas steel needles infiltrate more readily.