Postinfusion Phlebitis in Infants and Children

Infusion phlebitis occurs commonly in infants and children. The high frequency of phlebitis in infants with cutdowns appears to be the result of complete blocking of a small peripheral vein, thus not permitting the dilution and buffering of the infusate with blood. Generally, peripheral cutdowns should be used only when needle puncture is not feasible or when large fluid infusions or blood replacement are necessary. The acid pH of most commonly used glucose infusion solutions (3 to 5) causes chemical irritation to the endothelium which is then followed by inflammation and thrombosis. Buffering of glucose infusions with sodium bicarbonate immediately prior to administration has reduced the incidence of phlebitis in infants and children very significantly at the UCLA Hospital. A discussion of the major contributing factors to infusion phlebitis is presented here.