Background: The use of peripheral intravenous cannulas (IVCs) for the purpose of providing fluid and medications to the newborn is a consistent requirement in Neonatal Intensive Care Units (NICUs). Proper securement of cannulas can preserve catheter life. However; no consensus is available on the factors affecting the duration of patency. The present study was a randomized controlled trial designed to compare the effect of limb splinting versus non-splinting with the functional duration of peripheral IV cannula in neonates requiring IV infusion and/or medications.
Methods: This prospective interventional study was conducted over a period of 5 months in the NICU of Father Muller Medical College. Eligible cannulations were randomised to either ‘‘splint’’ or ‘‘no-splint’’ group. In the splint group, firm splint covered with sterile gauze was used to immobilise the joint at the peripheral IV cannula site. No attempt was made to immobilise the limb in the no-splint group. Duration from time of insertion to removal on the basis of predefined criteria was measured.
Results: A total of 449 peripheral IV cannulations in 390 newborns were randomized to either the splint (n= 230) or no-splint group (n=219). After exclusion, 202 cannulations in the splint group and 184 cannulations in the no-splint group were analyzed. The median survival time of IVC in the splint group was marginally more compared to the no-splint group (h; 51.08 hours (SD 32.6) vs. 50.93 (SD 33.1), mean difference 0.9 hours, p value 0.807). Extravasation at the peripheral infusion site was the commonest indication for cannula removal in both the groups occurring more in the splint group (93.6 % versus 85.3%).
Conclusions: This study concludes that the application of limb splinting for intravenous cannulation only marginally prolongs the duration of the cannula and thus may not be useful. The authors believe that there is a need for more larger, planned RCTs involving specific variables to come to scientifically valid, evidence- based guidelines.
Intravenous cannula, Splint, Neonate