Limb Splinting for Intravenous Cannulas in Neonates: A Randomized Controlled Trial

Shamsher Singh Dalal ¹, Deepak Chawla ², Jyoti Singh ¹, Rameh K Agarwal ^1*, Ashok Kumar Deorari ¹ and Vinod Paul ¹

¹ All India Institute of Medical Sciences, New delhi, India
² Goverenment Medical College, Chandigarh, India

^* To whom correspondence should be addressed. E-mail: aranag{at}rediffmail.com.

Accepted 27 April 2009

Abstract

Objective: To evaluate the efficacy of peripheral intravenous cannula (PIVC) site joint immobilization by splint application on functional duration of PIVC in neonates.

Design: Randomized controlled trial.

Setting: Neonatal Intensive Care Unit (NICU) of a tertiary care hospital.

Participants: Neonates requiring continuous intravenous infusion for an expected duration of more than or equal to 72 hours.

Intervention: Eligible cannulations were randomized to either Splint or No-Splint group. In Splint group, a cardboard splint was used to immobilize the joint at PIVC site. No attempt was made to immobilize the limb in No-Splint group.

Outcome measure: Functional duration of PIVC measured as interval from time of insertion to the development of predefined sign of removal (extravasation, blockage, inflammation).

Results: A total of 69 peripheral intravenous cannulations in 54 neonates were randomized to either Splint (n=33) or No-Splint group (n=36). Both groups were comparable in birth weight, gestation, site of cannulation and nature of fluids administered. Mean functional duration of canula was lesser in Splint group compared to No-Splint group (h; 23.5±15.9 vs. 26.9±15.5, mean difference: –3.3 h, 95% CI: –11.02 to 4.3 h) although the difference was not statistically significant (p=0.38). Extravasation at cannula site was found be the commonest indication for cannula removal in both the groups (84% vs 76.5%).

Conclusion: Joint immobilization with splint at cannula site did not improve the functional duration of PIVC.