Definition & Overview

Intravenous therapy is the method of administering liquid medication directly into a vein. Because of the use of drip chamber, the infusions are often termed drips while the drugs that are introduced intravenously are called specialty pharmaceuticals or specialty drugs.

Intravenous therapy delivers two types of fluids, crystalloids and colloids. Crystalloids are liquid forms of minerals, salts, and other water-soluble substances. Examples are saline solution, dextrose in water, and Ringer’s lactate. Most physicians administer crystalloids to dehydrated patients and those who require electrolyte replacement. On the other hand, colloids are water-insoluble molecules. There are generally large particles in colloid solutions that are used for blood replacement, volume expansion, and maintaining normal blood pressure.

Intravenous therapy offers several benefits including the quick delivery of drugs into the system and the assurance of complete bioavailability of the medication.

Who Should Undergo and Expected Results

Intravenous therapy is recommended for:

  • Cancer patients undergoing chemotherapy - These patients require intravenous therapy to deliver the pharmaceutical drugs into their system. The duration of treatment depends on the type of cancer being treated and its severity. Intravenous treatment lasting only for a few hours can be administered in an outpatient setting. However, there are chemotherapy drugs that require continuous infusion in which the patient has to carry a small pump that administers the drugs for over long periods of time. Intravenous therapy is also indicated for administering drugs for other medical conditions like acidosis and alkalosis.

  • Severely dehydrated patients – These patients may also be given intravenous therapy to deliver fluid replacement in the fastest way possible.

  • Blood transfusion patients - Patients who have lost a substantial amount of blood either due to injury or surgical procedure can be placed under intravenous therapy. Depending on the need, only blood components maybe infused into the patient’s bloodstream instead of whole blood. Blood components include red blood cells, platelets, white blood cells, plasma, and clotting factors. Additionally, patients who are experiencing poor oxygen saturation in their blood and those who are diagnosed with cardiovascular diseases may also require a blood transfusion.

  • Patients with electrolyte imbalance - The therapy is also appropriate for those exhibiting symptoms of electrolyte imbalance due to altered levels of important elements in the blood. These electrolytes include potassium, calcium, sodium, and magnesium. If left untreated, this condition could lead to twitching, convulsions, general weakness, and muscle spasms.

  • Malnourished patients - Through intravenous therapy, nutritional formulas and vitamins enter the body directly into the bloodstream for faster uptake and use.

How is the Procedure Performed?

There are several factors that a medical personnel has to consider before initiating intravenous therapy. These include the type of solution to be administered, duration of therapy, condition of the vein, size of the catheter, and a number of patient-related factors such as age and activity. Before puncturing the vein, the personnel has to dilate it using several techniques such as placing the limb lower than the heart, tapping the vein, fist clenching, using warm compress, or using a tourniquet. The selected site for needle insertion has to be cleaned with an antimicrobial solution applied in a circular motion. Typically, a tourniquet is attached firmly above the puncture site to distend the vein. A needle catheter is then inserted and the tourniquet released. The needle is then carefully removed, leaving the catheter hub where the infusion tubing is attached. Once the attachment has been stabilised, the medical personnel can then initiate the infusion while the catheter is held in place by medical tapes.

In some cases, the intravenous therapy site is in the neck or chest area. For chemotherapy patients, a central venous catheter or a central line is used to administer the needed drugs into the patient’s system.

Possible Risks and Complications

With a high risk of developing infection at the injection site, care has to be taken to make sure that the entire needle and catheter insertion process is kept sterile.

Toxicity and damage to the vein can also occur if the drugs are administered too rapidly. This can lead to the occurrence of phlebitis or inflammation of the veins.

The improper insertion of the needle can also cause leakage of medication into the surrounding parts instead of going directly into the blood.

Though rare, there is also the risk of air embolism if air bubbles enter the vein. This can lead to problems in blood circulation and breathing.

The use of intravenous therapy can also lead to the occurrence of blood clots and deep vein thrombosis that can be fatal if left unattended.

Another rare complication is the development of allergic reactions to the drugs being administered. This necessitates careful monitoring of the patient while undergoing this form of therapy.

References:

  • Immune Deficiency Foundation: “Immunoglobulin Therapy & Other Medical Therapies for Antibody Deficiencies.”

  • American Academy of Allergy, Asthma and Immunology: “Eight Guiding Principles for Effective Use of IVIG for Patients with Primary Immunodeficiency.”

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