Perlukah Penggantian Rutin Kanula Infus?

Oleh :

dr. Andrian Yadikusumo, Sp.An

Penggantian kanula infus atau kateter intravena secara rutin setiap 72–96 jam telah lama menjadi bagian dari protokol pencegahan infeksi nosokomial, terutama untuk mencegah tromboflebitis dan infeksi aliran darah terkait kateter (catheter-related blood stream infection/CRBSI). Namun, seiring berkembangnya praktik berbasis bukti dan kesadaran terhadap efisiensi penggunaan sumber daya, pendekatan ini mulai dikaji ulang.

Beberapa fasilitas kesehatan kini mulai menerapkan kebijakan penggantian kanula infus berdasarkan indikasi klinis, yaitu hanya saat terdapat tanda komplikasi seperti nyeri, kemerahan, sumbatan, atau infiltrasi. Pendekatan ini diharapkan dapat mengurangi beban kerja perawat, menghemat biaya, dan meningkatkan kenyamanan pasien.[1-6]

Basis Bukti Penggantian Kanula Infus Rutin vs Berdasarkan Indikasi Medis

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Webster J, Osborne S, Rickard CM, Marsh N. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2019;2019(1):CD007798.
2. Ray-Barruel G, Xu H, Marsh N, Cooke M, Rickard CM. Sites and methods of peripheral intravenous catheter securement: A randomized controlled trial. J Adv Nurs. 2020;76(4):1137–49.
3. Larsen EN, Marsh N, Salm P, Rickard CM, Webster J. Peripheral intravenous catheter replacement: A randomized controlled trial of three securement methods. BMJ Open. 2017;7(8):e015443.
4. Buetti N, Abbas M, Pittet D, et al. Comparison of Routine Replacement With Clinically Indicated Replacement of Peripheral Intravenous Catheters. JAMA Intern Med. 2021;181(11):1471–8
5. Rickard CM, Webster J, Wallis MC, et al. Routine vs clinically indicated replacement of peripheral intravenous catheters: a randomized controlled equivalence trial. Lancet. 2012;380(9847):1066–74
6. Gorski LA, Hadaway L, Hagle ME, Broadhurst D, Clare S, Kleidon T, Meyer BM, Nickel B, Rowley S, Sharpe E, Alexander M. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021 Jan-Feb 01;44(1S Suppl 1):S1-S224.
7. Chen CY, Chen WC, Chen JY, Lai CC, Wei YF. Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2022; 9:964096. doi: 10.3389/fmed.2022.964096.
8. CDC. Summary of Recommendations Guidelines for the Prevention of Intravascular Catheter-Related Infections. 2024. https://www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infections/summary-recommendations.html#cdc_generic_section_14-14-replacement-of-peripheral-and-midline-catheters
9. WHO. Guidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters. Part I: peripheral catheters. 2024. https://iris.who.int/bitstream/handle/10665/376722/9789240093829-eng.pdf?sequence=1