***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 
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    ***EXAMPLES*** 
    Input: We carried out a double-blind prospect i ve study of the effect of a filter on the incidence of  phlebitis associated with intravenous infusion in 541 patients . A total of 277 patients received infusions through intravenous sets with 0.22-micron IVEX-HP filters , and 264 received infusions without filters . Each infusion was evaluated daily for a maximum of three days . The incidence of phlebitis on Days 1 , 2 , and 3 of the study was 14.3 , 31.1 , and 27 per cent for patients receiving infusions without filters and 6.8 , 9.7 , and 11.3 per cent for those receiving infusions through the filters ( P less than 0.001 ) . Thus , the incidence was reduced by approximately two thirds in the patients who received infusions through the IVEX-HP filters . We conclude that infusion-related phlebitis is a pervasive problem in hospitalized patients , and that it is usually caused by microparticulate components that are present in the infusion fluids and can be removed by in-line filtration 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 A double-blind study was conducted to determine the effectiveness of 5-mum final filtration in preventing phlebitis secondary to intravenous fluid administration . An experimental administration set which contained distal portion of the tubing was used for patients r and omly assigned to receive  filtered intravenous solutions . An identical administration set minus the filter was used in the control group to allow double-blind evaluation of the injection site . Data were collected on 49 patients whose average age was eight years and one month . Most patients had a primary diagnosis of acute lymphocytic or myelocytic leukemia or solid tumor . The patients ' injection sites were evaluated daily for clinical findings of phlebitis ( erythema , in duration , heat , erythematous-streak and discomfort ) . The incidence of phlebitis was significantly lower ( p less than 0.01 ) in patients receiving filtered intravenous solutions . For the patients in this study , filtration of intravenous fluids with a 5-mum mesh filter appeared to be a feasible and effective means of reducing postinfusion complications 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 We found clinical phlebitis in 57 of 88 patients with peripheral hyperalimentation ( 65 % ) . To determine if this was a problem common to all intravenous fluid therapy at our hospital , we performed a point-prevalence study . The prevalence of phlebitis in nonhyperalimentation intravenous patients was 18 % ( 84 of 456 patients ) . We then performed a r and omized , prospect i ve , double-blind trial of sham versus st and ard in-line filters to determine if bacteria or filterable particulate matter was responsible for phlebitis in the peripheral hyperalimentation group . The st and ard-filter group had a phlebitis rate of 74 % compared with 64 % in the sham-filter group . We then eliminated in-line filters and replaced the st and ard glucose-based solution with a glycerol-based peripheral hyperalimentation solution . The phlebitis rate decreased from 68 % to 27 % ( p less than 0.001 ) . In conclusion , phlebitis in peripheral hyperalimentation patients was probably due to chemical properties of the peripheral hyperalimentation solution rather than bacteria or particulates Infusion phlebitis is the most common complication of intravenous therapy . Six methods of reducing the incidence of infusion phlebitis including inline final filtration , buffers , heparin , hydrocortisone , heparin-hydrocortisone combinations , and frequent set changes were tested in a two part r and omized prospect i ve double-blind study of 266 surgical patients . Patients who received filtered fluids  had a significantly decreased incidence of infusion phlebitis as compared with that of controls ( P = 0.0000001 ) . Of the other methods tested , only the heparin-hydrocortisone combinations achieved any significant decrease in phlebitis ( P less than 0.5 ) . Therefore , inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a routine part of intravenous therapy The incidence of intravenous complications ( phlebitis ) and the length of hospital stay in postoperative patients whose infusions were filtered through inline final filters were compared with those in patients whose infusions were not filtered . Identical i.v . solutions were administered to 150 postoperative orthopedic patients r and omly assigned to three study groups : control ( no filter ) , 5-micrometers membrane filter and 0.45-micrometers membrane filter . An i.v . therapy team of seven nurses inspected patients for phlebitis . The phlebitis rate of the control group ( 27 % ) was significantly greater ( p less than 0.05 ) than that of the 0.45-micrometers filter group ( 6 % ) but not significantly different ( p less than 0.9 ) from that of the 5-micrometers filter group ( 22 % ) . In a subgroup of 104 patients undergoing total hip replacement , the mean reduction in length of postoperative hospital stay compared with the control group ( 13.6 days ) was : 5-micrometers filter group--3.4 days ( p less than 0.01 ) ; and 0.45-micrometer filter group--3.3 days ( p less than 0.01 ) . The results suggest that final filters can be used to reduce the incidence of phlebitis-related i.v . complications and thereby reduce the length of hospital stay The effect of inline i.v . filters on  postinfusion phlebitis ( PIP ) and bacterial colonization of i.v . catheters was evaluated . The subjects of the prospect i ve double-blind study were 195 men undergoing elective surgery .  Polyethylene i.v . catheters of varying sizes were inserted the morning of surgery . Before catheterization , each site was shaved and cleansed with 1 % povidone-iodine solution . In the experimental group , all i.v . fluids , additives , and medications were administered through a 0.22-micron micropore inline final filter . In the control group , no membrane filter was present in the filter housing . Drug and fluid therapy were determined by the physician , and flow rates were maintained at 40 ml/hr if not specified . Every 12 hours , sites were inspected and observations were grade d according to criteria adapted from an earlier study . The incidence of phlebitis in the two groups was compared . At the termination of i.v . therapy , catheters were removed and cultured . The incidence of PIP in the experimental group ( 38/95 ) and the control group ( 39/100 ) was not significantly different . There were no differences between groups in variables possibly related to the occurrence of PIP , such as patient age , i.v . flow rate , catheter size , and use of potassium chloride i.v . additive . Of 141 i.v . catheters that were cultured , 25 yielded 10 or more colonies per plate ; 21 were coagulase-negative staphylococci . Positive cultures occurred as frequently in patients without filters as in those with filters . No patient had clinical evidence of bacteremia . In these general surgical patients , inline filters did not affect the incidence of PIP or bacterial colonization of i.v . catheters . While the use of inline filters to prevent infusion of microorganisms deserves consideration , their routine use as a means of reducing PIP is unwarranted The effect of final filtration on the incidence of infusion phlebitis  was studied in a prospect i ve , double-blind investigation involving 146 postoperative patients . The incidence of infusion phlebitis was found to be significantly reduced when an inline , 0.45-mum membrane filter was used . The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy . Buffering the infusion fluid or 24-hour change of the administration set did not have any effect on reducing the incidence of phlebitis .  Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed . A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids . It is recommended that inline final filters should be a part of routine intravenous therapy Methods which might be useful in preventing cephalothin-induced  phlebitis following intravenous administration of the buffered drug were investigated . One hundred and twenty adult orthopedic patients were assigned r and omly to either a control group or one of five treatment groups . The treatment regimens studied were : addition of hydrocortisone phosphate 10 mg to each liter of intravenous fluid ; addition of heparin 1,000 units to each liter of intravenous fluid ; addition of heparin 500 units and hydrocortisone phosphate 1 mg to each liter of intravenous fluid ; addition of heparin 1,000 units and hydrocortisone phosphate 10 mg to each liter of intravenous fluid ; and filtration of intravenous solutions through a 0.22-mum inline filter . All patients in the study received intravenous buffered cephalothin at a dosage of 1 g every six hours for a minimum of 48 hours . Phlebitis was assessed every 12 hours according to predetermined criteria . Significant differences were found in the incidence of phlebitis at 48 hours between the control group and the last three study groups ( see above ) . It is concluded that postinfusion phlebitis following cephalothin administration can be reduced by the concomitant addition of heparin and hydrocortisone to the intravenous solution or by the use of an inline 0.22-mum final filter 1 Szczeklik , A , G 
    Output:
    
The estimated benefit did not depend on baseline risk .