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Neutralization of Prostaglandin E1 Intravenous Solution Reduces Infusion Phlebitis

Masafumi Shimizu, MD

Hiroshi Yoshizu, MD

Daisuke Segawa, MD

Tamizou Kimura, MD

Yasuhiro Iizuka, MD

Susumu Tanaka, MD

Masanori Fujita, MD

Department of Surgery National Defense Medical College 3-2, Namiki, Tokorozawa Saitama, 359-8513, Japan

Previous studies have shown moderate or severe phlebitis at the site of venipuncture in some patients who receiving prostaglandin E₁ (PGE₁) infusion therapy. Such phlebitis is sometimes severe enough to necessitate the cessation of PGE₁ therapy.

This study investigated how to continue PGE₁ infusion therapy for 3 weeks with tolerable phlebitis. Although a 60 µg dose of PGE₁ is usually dissolved in 500 mL of fluid to avoid phlebitis, we used 200 mL to prevent volume overload. This PGE₁ solution was neutralized to pH 7.4 with 4 mL of 7% sodium bicarbonate. We examined the frequency and severity of phlebitis among patients who received a 2-h PGE₁ infusion twice daily.

Eighteen patients who were hospitalized for peripheral vascular disease between June 1998 and May 1999 were studied. All of them were men and their mean age was 63.3 ±8.9 years (range: 47-78 years). Fourteen patients had arteriosclerosis obliterans and four had Buerger's disease. When the severity of phlebitis was determined according to Dinley's criteria, two patients (11%) had grade 0, four patients (22%) had grade 1, eleven patients (61%) had grade 2, and one patient (6%) had grade 3 phlebitis. Usually, PGE₁ infusion therapy is stopped when phlebitis reaches grade 4 or more, but there were no such cases in this study. We also found that aging was significantly correlated with a decrease in the severity of phlebitis (Spearman's rank correlation test: r = -0.545, p = 0.0193).

Angiology, Vol. 51, No. 9, 719-723 (2000)
DOI: 10.1177/000331970005100903


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