Gorbea 1984.

Methods	Alternately allocated controlled clinical trial
Participants	123 adult patients in a surgical ICU who required IV therapy for the required period of time. Hospital, USA
Interventions	Administration set changes at 24 or 48 hours
Outcomes	Infusate colonization IR‐BSI CR‐BSI All‐cause BSI
Notes	Exclusions: patients receiving PN through a central line. Confounders: The 24 hour group had a greater no. of catheters/participant and a greater proportion receiving antibiotics Central catheters: 38% PN: 0% (central), not stated for peripheral Loss to follow‐up: 22%
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Poor random sequence generation; easily predictable Quote: "alternatively assigned"
Allocation concealment (selection bias)	High risk	Not feasible because of poor sequence generation
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not discussed, not feasible because of research design
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not discussed, not feasible because of research design
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Outcome blinding possible but not discussed
Incomplete outcome data (attrition bias) All outcomes	Low risk	Attrition adequately described 157 enrolled, 34 dropouts (15 in 24 hours, 19 in 48 hours) because of early discharge or death
Selective reporting (reporting bias)	Low risk	No pre‐protocol
Other bias	High risk	Difference in baseline characteristics of concern More CVCs (49 vs 30) in 24 hour group More cultures for all outcomes completed in 24 hour group 24 hour group significantly increased injections, increased antibiotics, increased length of ICU stay 24 hour group required only 24 hour minimum stay in ICU (or they were excluded); 48 hour group had to stay in ICU 48 hours (or they were excluded)