How often should I change the IV administration set?
A large randomised controlled trial found that administration sets used for crystalloids, non-lipid parenteral nutrition, and medication infusions could be safely used for 7 days in short-term and long-term central venous catheters, as well as in peripheral arterial catheters [1]. Bloodstream infections did not differ between groups with sets changed every 7 or 4 days. This trial was in adults and children in a range of settings such as intensive care and cancer units. An earlier systematic review suggested that mortality increased within the neonatal population with infrequent administration set replacement, although the level of evidence was low-moderate quality, meaning there remains uncertainty in this population.
Avoiding unnecessary administration set replacement reduces costs, workloads and environmental manufacture and waste. In addition, avoiding disconnections of the administration set can avoid bacterial contamination. However, it is possible that administration sets can become contaminated and be a reservoir for infection. Because of this, if a patient has a new fever of unknown origin, and the vascular access device is to remain in place, the administration sets could all be replaced at this time. In addition, if there is any malfunction (e.g., leaking, clamp failure) or particulate matter observed within the sets, they should also be replaced immediately.
References:
1. Rickard CM, Marsh NM, Larsen EN, McGrail MR, Graves N, Runnegar N, Webster J, Corley A, McMillan D, Gowardman JR, Long DA, Fraser JF, Gill FJ, Young J, Murgo M, Alexandrou E, Choudhury MA, Chan RJ, Gavin NC, Daud A, Palermo A, Regli A, Playford EG. Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)-non-inferiority (peripheral arterial catheter) trial. Lancet. 2021 Apr 17;397(10283):1447-1458. doi: 10.1016/S0140-6736(21)00351-2. PMID: 33865494.
Last Updated on: 15/01/2025
