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.