pH of Infusion Fluids: A Predisposing Factor in Thrombophlebitis

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Abstract
To the Editor.— It is known that the pH of glucose infusion fluids sterilized by autoclaving is maintained in the vicinity of 4.0 in order to prevent caramelization during the sterilization procedure. The acidity of these solutions has long been suspected as an important factor in the development of infusion thrombophlebitis.1,2Controlled studies by Elfving and Saikku3and Fonkalsrud et al4clearly demonstrated a significant decrease in the incidence of thrombophlebitis when buffered glucose solutions (buffered to pH 6.8 and 7.4, respectively) were used. Recently we have measured the pH of some commonly used intravenously given fluids. With the exception of lactated Ringer's solution, all were found to be acidic (Table). These solutions have no significantbuffering capacity and are easily buffered by blood. A ready explanation for the genesis of infusion phlebitis lies in the relative sizes of the needle or polyethylene catheter and the vein