Association between continuous peripheral i.v. infusion of 3% sodium chloride injection and phlebitis in adults

Am J Health Syst Pharm. 2018 Mar 1;75(5):284-291. doi: 10.2146/ajhp161028.


Purpose: One institution's experience with use of peripheral i.v. (PIV) catheters for prolonged infusions of 3% sodium chloride injection at rates up to 100 mL/hr is described.

Methods: A prospective, observational, 13-month quality assurance project was conducted at an academic medical center to evaluate frequencies of patient and catheter phlebitis among adult inpatients who received both an infusion of 3% sodium chloride injection for a period of ≥4 hours through a dedicated PIV catheter and infusions of routine-care solutions (RCSs) through separate PIV catheters during the same hospital stay.

Results: Sixty patients received PIV infusions through a total of 291 catheters during the study period. The majority of patients (78%) received infusions of 3% sodium chloride injection for intracranial hypertension, with 30% receiving such infusions in the intensive care unit. Phlebitis occurred in 28 patients (47%) during infusions of 3% sodium chloride and 26 patients (43%) during RCS infusions (p = 0.19). Catheter phlebitis occurred in 73 catheters (25%), with no significant difference in the frequencies of catheter phlebitis with infusion of 3% sodium chloride versus RCSs (30% [32 of 106 catheters]) versus 22% [41 of 185 catheters]), p = 0.16).

Conclusion: Patient and catheter phlebitis rates were not significantly different with infusions of 3% sodium chloride injection versus RCSs, suggesting that an osmolarity cutoff value of 900 mOsm/L for peripheral infusions of hypertonic saline solutions may not be warranted.

Keywords: adverse drug event; adverse drug reaction; hyperosmolar agents; hypertonic saline; osmotherapy; phlebitis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Compounding
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Phlebitis / chemically induced*
  • Phlebitis / diagnosis
  • Phlebitis / epidemiology*
  • Prospective Studies
  • Saline Solution, Hypertonic / administration & dosage*
  • Saline Solution, Hypertonic / adverse effects*
  • Sodium Chloride / administration & dosage
  • Sodium Chloride / adverse effects


  • Saline Solution, Hypertonic
  • Sodium Chloride