To splint or not to splint: securing the peripheral intravenous cannula

Peripheral intravenous cannulae in neonates: To splint or not?

OBJECTIVE

To determine the effect of splint on the dwell time of peripheral intravenous cannula in neonates.

SETTING

Level II Neonatal Intensive Care Unit (NICU).

PATIENTS

Consecutive babies with presumed need of peripheral intravenous access of at least 24 h.

METHODS

Enrolled subjects were randomized to "splint" or "splint-less" group. Insertion site was cleaned with Isopropyl alcohol and 2% Chlorhexidine and peripheral intravenous catheter was inserted under strict asepsis. Insertion sites was examined regularly for occurrence of complication which necessitated removal of the catheter.

RESULTS

Out of 159 neonates, 80 were allotted to splint group and the rest to splint-less group. Mean dwell time of intravenous line in splint group was 27.68 ± 13.03 h which was significantly less than in splint-less group (32.87 ± 15.79 h, mean difference: 5.11 h, p value: 0.03). Subgroup analysis in preterms showed mean dwell time of 28.54 ± 14.86 h in splint group which was less than that of splint-less group (35.10 ± 16.24 h) (p value: 0.03). No such difference was noted in the term neonates. Subgroup analysis for catheters put across joints does not show difference in mean dwell times between splint and splint-less groups. Multivariate regression analysis did not identify any variable which independently affected the outcome.

CONCLUSION

Use of splint does not prolong the dwell time of the catheter and is probably harmful in some neonates.