Objectives: To study the preventive effect of dexamethasone solution pre-treated catheter on Peripherally Inserted Central Catheter (PICC)-induced phlebitis.
Methods: 320 cases of patients undergone PICC in our hospital between Aug., 2013 and Aug., 2016 were selected and randomly divided into control group and observation group with 160 cases respectively. The observation group was in turn separated into high concentration group and low concentration group with 80 cases of each group. To find out the effects and the best concentration of dexamethasone solution in preventing PICC-induced phlebitis, we compared the occurrence of phlebitis and some other complications of these three groups by immersing the catheters of high concentration group, low concentration group and control group in 30 ml of 0.08 mg/ml, 0.04 mg/ml dexamethasone and saline respectively before placing catheters.
Results: There were no statistical significance of the differences in general clinical data and catheter placement (P>0.05). The occurrence time of phlebitis in the high concentration group were later than that in the low concentration group, the incidences of phlebitis were lower than that in the low concentration group (P<0.05). The occurrence time of phlebitis in the low concentration group were later than that in the control group, the incidences of phlebitis were lower than that in the control group (P<0.05). The degree of phlebitis in high concentration group and low concentration group was lower than that in control group (P<0.05) and there was no significant difference in the degree of phlebitis between the high and the low concentration group (P>0.05). The differences were not statistically significant in the comparison of other early complications (P>0.05). Multivariate regression analysis showed that the pre-treatment of catheters by dexamethasone solution is an independent favoring risk factor for the incidence of phlebitis (OR 0.56, 95% CI (0.43-0.78), P<0.001).
Conclusions: The pre-treatment of catheters by dexamethasone solution can obviously reduce the incidences and degree of PICC-induced phlebitis, delay its occurrence without leading to the ascent of risks of other complications. It has the best preventive effect to do the pre-treatment of catheter by using 30 ml dexamethasone solution with a concentration of 0.08 mg/ml, but the time for pre-treatment still needs further exploration.