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Limb Splinting for Intravenous Cannulas in Neonates: A Randomized Controlled Trial
  1. Shamsher Singh Dalal
  1. All India Institute of Medical Sciences, New delhi, India
    1. Deepak Chawla
    1. Goverenment Medical College, Chandigarh, India
      1. Jyoti Singh
      1. All India Institute of Medical Sciences, New delhi, India
        1. Rameh K Agarwal (aranag{at}rediffmail.com)
        1. All India Institute of Medical Sciences, New delhi, India
          1. Ashok Kumar Deorari
          1. All India Institute of Medical Sciences, New delhi, India
            1. Vinod Paul (vinodkpaul{at}hotmail.com)
            1. All India Institute of Medical Sciences, New delhi, India

              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.

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