***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim : This study assesses the improvement in outcome for newborn infants by decreasing major complications associated with intravenous fluid therapy by using an in‐line filter , and evaluates the economical impact this might have in relation to daily changing of i.v . lines . Methods : In a prospect i ve controlled study , 88 infants were r and omly assigned to receive either filtered ( except for lipids , blood and blood products ) or non‐filtered infusions via a central catheter . Main outcome measures such as bacteraemia , phlebitis , extravasation , thrombosis , septicaemia and necrosis were all scored . The costs attributable to patients during a st and ard 8‐day stay were also recorded . Results : Significant reductions were found in major complications such as thrombi and clinical sepsis ( control group ( 21 ) , filter group ( 8) ; p < 0.05 ) . Bacterial cultures of the filters showed a contamination rate on the upstream surface of 15/109 filters ( 14 % ) . The mean costs of disposables were less in the filter group , showing a reduction from ±31.17 to ±23.79 Purpose Particulate contamination due to infusion therapy carries a potential health risk for intensive care patients . Methods This single-centre , prospect i ve , r and omized controlled trial assessed the effects of filtration of intravenous fluids on the reduction of complications in critically ill children admitted to a pediatric intensive care unit ( PICU ) . A total of 807 subjects were r and omly assigned to either a control ( n = 406 ) or filter group ( n = 401 ) , with the latter receiving in-line filtration . The primary endpoint was reduction in the rate of overall complications , which included the occurrence of systemic inflammatory response syndrome ( SIRS ) , sepsis , organ failure ( circulation , lung , liver , kidney ) and thrombosis . Secondary objectives were a reduction in the length of stay on the PICU and overall hospital stay . Duration of mechanical ventilation and mortality were also analyzed . Findings Analysis demonstrated a significant reduction in the overall complication rate ( n = 166 [ 40.9 % ] vs. n = 124 [ 30.9 % ] ; P = 0.003 ) for the filter group . In particular , the incidence of SIRS was significantly lower ( n = 123 [ 30.3 % ] vs. n = 90 [ 22.4 % ] ; P = 0.01 ) . Moreover the length of stay on PICU ( 3.89 [ 95 % confidence interval 2.97−4.82 ] vs. 2.98 [ 2.33−3.64 ] ; P = 0.025 ) and duration of mechanical ventilation ( 14.0 [ 5.6−22.4 ] vs. 11.0 [ 7.1−14.9 ] h ; P = 0.028 ) were significantly reduced . Conclusion In-line filtration is able to avert severe complications in critically ill patients .  The overall complication rate during the PICU stay among the filter group was significantly reduced . In-line filtration was effective in reducing the occurrence of SIRS . We therefore conclude that in-line filtration improves the safety of intensive care therapy and represents a preventive strategy that results in a significant reduction of the length of stay in the PICU and duration of mechanical ventilation ( Clinical Trials.gov number : NCT00209768 ) Phlebitis is the most common complication of intravenous therapy affecting more than 50 per cent of infusions . Particles in or added to infusions have been implicated , hence a filter with pore size of 0.2/ μm containing both hydrophobic and hydrophilic elements ( Pall Biomedical ) has been evaluated . All infusions of likely duration greater than 48 h , set up in a 2‐month period at this hospital , were r and omized to filter or identical dummy . The endpoints and statistical power of the study were determined at the outset . Of the 226 infusions r and omized , 32 failed within 24 h and were excluded leaving 194 of whom 93 had dummy and 101 filter . Only 38 infusions with dummy survived until no longer required compared to 63 infusions with filter ( χ2 = 7.68 , P < 0.01 ) . Analysed by life table , the trend for filtered infusions to survive longer failed to achieve statistical significance , but inline filtration prolonged the phlebitis‐free survival of infusions ( P < 0.01 ) . These benefits were most marked in the 49 infusions where antibiotics were administered via the drip site . Inline filtration delays the onset of phlebitis , thus more infusions survive until they are no longer required . This effect is not sufficiently strong to institute an overall hospital policy but filters may be indicated in patients requiring intravenous antibiotics OBJECTIVE : To compare the use of in-line filtration with the addition of heparin/hydrocortisone ( hep/hc ) to the infusate for both phlebitis prevention and intravenous(iv ) line survival in peripheral iv catheters . This study was specific for a patient group receiving prolonged courses of iv antibiotics . Analysis of the two endpoints for conventional short iv catheters ( short lines ) versus long ( 30 cm ) iv catheters ( long lines ) was also performed . METHODS : Patients with cystic fibrosis receiving intermittent iv antibiotics were r and omly allocated to receive their drugs either through an in-line filter using a drug-free infusate or with no filter and an infusate containing heparin 500 units and hydrocortisone 10 mg/L. Infusion sites were assessed daily . RESULTS : Both the hep/hc and filter groups were similar in terms of phlebitis incidence and iv line survival when analyzed separately for both short and long lines . Long lines displayed markedly prolonged survival times and reduced phlebitis compared with short lines . CONCLUSIONS : The effectiveness of iv filters in excluding the large particle load introduced by iv antibiotics and hence in reducing the subsequent phlebitis makes them a useful alternative to the use of hep/hc . The use of filters in this patient group may offer advantages in terms of ease of use and a possible decrease in hep/hc-related problems . Long lines offer practical advantages over short lines for patients requiring longer term iv access OBJECTIVE To identify risk factors for  infusion-related phlebitis with peripheral intravenous catheters . DESIGN A r and omized trial of two catheter material s , with consideration of 21 potential risk factors . SETTING A university hospital . PATIENTS Hospitalized adults without granulocytopenia who received a peripheral intravenous catheter .  INTERVENTIONS House officers or ward nurses inserted the catheters , and each insertion was r and omized to a catheter made of tetrafluoroethylene-hexafluoropropylene ( FEP-Teflon ) or a novel polyetherurethane without leachable additives ( PEU-Vialon ) . MEASUREMENTS Research nurses scored insertion sites each day for inflammation and cultured catheters at removal . RESULTS The Kaplan-Meier risk for phlebitis exceeded 50 % by day 4 after catheterization . intravenous antibiotics ( relative risk , 2.00 ) , female sex ( relative risk , 1.88 ) , prolonged ( greater than 48 hours ) catheterization ( relative risk , 1.79 ) , and catheter material ( PEU-Vialon : FEP-Teflon ) ( relative risk , 0.73 ) strongly predicted phlebitis in a Cox proportional hazards model ( each , P less than 0.003 ) . The best-fit model for severe phlebitis identified the same predictors plus catheter-related infection ( relative risk , 6.19 ) , phlebitis with a previous catheter ( relative risk , 1.54 ) , and anatomic site ( h and : forearm , relative risk , 0.71 ; wrist : forearm , relative risk , 0.60 ) . The low incidence of local catheter-related infection was comparable with the two catheter material s ( 5.4 % [ 95 % CI , 3.8 % to 7.6 % ] and 6.9 % [ CI , 4.9 % to 9.6 % ] ) ; none of the 1054 catheters prospect ively studied caused bacteremia . CONCLUSIONS Multiple factors , including the infusate and the duration of cannulation , contribute to the development of infusion-related phlebitis . The use of peripheral intravenous catheters made of PEU-Vialon appears to pose the same risk for catheter-related infection as the use of catheters made of FEP-Teflon , and PEU-Vialon can permit longer cannulation with less risk for phlebitis . The risk for catheter-related bacteremia with FEP-Teflon and PEU-Vialon catheters is sufficiently low that it no longer seems justifiable to recommend the use of small steel needles for most peripheral intravenous therapy The National Institute of Child Health and Human Development conducts and supports research on all stages of human development from preconception to adulthood in order to better underst and the health of children , youths , adults , families , and communities . Health and human development information is made easily available on the site with a simple A to Z list , along with clinical trials and health education campaign information . Links to clinical trials , news releases , publications , and related web sites are also available , as well as information on research being conducted at present and supported by the National Institute of Child Health and Human Development This study arose from a need to justify the extensive use of in-line intravenous filters in an Australian pediatric teaching hospital . The incidence of septicemia was observed for two 12-month periods before and after the withdrawal of in-line i.v . filters from patients with central venous access devices . A total of 19,221 i.v . days were monitored in 88 children in two 1-year periods . No significant differences were found in the incidence of septicemia between the children who had filters fitted and those who did not . As a result , the routine fitting of filters to i.v . lines infusing fluids filtered during manufacture under a laminar flow has been discontinued with significant cost savings Particulate contamination in small volume parenteral medications  has been studied and compared with that found in a selection of large volume infusions . Particle counts in 39 commonly used small volume medications and 7 large volume infusions were performed by an automated light blockage method ( HIAC ) or by optical microscopy . Based on these results and a r and om survey of drug therapy of intensive care patients , it is concluded that the contribution of intravenous medications to the total particle load received by such patients is likely to be many times greater than from infusion fluids . Until firm evidence regarding the harmful systemic effects of drug particles is available and the manufacturing regulations adjusted appropriately , final in-line filtration of infusions immediately proximal to the intravenous cannula should be considered when drugs are being given intravenously Abstract Nosocomial sepsis remains an important cause of morbidity in neonatal intensive care units . Central venous catheters ( CVCs ) and parenteral nutrition ( TPN ) are major risk factors . In-line filters in the intravenous ( IV ) administration sets prevent the infusion of particles , which may reduce infectious complications . We r and omized infants to in-line filter ( for clear fluids and lipid emulsions ) or no filter placement .  Sepsis , nursing time and costs were assessed . IV sets without filters were changed every 24 h , IV-sets with filters every 96 h. Of 442 infants with a CVC , 228 were r and omized to  filter placement , 214 to no filter . No differences were found in clinical characteristics , CVC-use , and catheter days . Nosocomial sepsis occurred in 37 ( 16.2 % ) infants with filters , in 35 ( 16.3 % ) in the group without filter ( NS ) . Nursing time to change the IV-administration sets was 4 min shorter in the filter-group ( P<0.05 ) . Costs of material s used were comparable . In conclusion , the incidence of sepsis when using filters was not reduced but the nursing time for changing the intravenous sets was reduced without a difference in costs 
    Output:
    
There is insufficient evidence to recommend the use of intravenous in-line filters to prevent morbidity and mortality in neonates