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Published on: August 8, 2025
Peripheral IVs: factors affecting complications and patency--a randomized controlled trial
Sandeep Tripathi1, Vidhu Kaushik, Varinder Singh
1Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India. sandeep.tripathi@downstate.edu
Summary
Heparin flushes and splints significantly increase peripheral intravenous catheter patency duration in pediatric patients. However, heparin flushes were linked to a higher phlebitis incidence, with younger age and specific insertion sites/catheter sizes increasing complications.
Area of Science:
- Pediatric Medicine
- Vascular Access Management
- Clinical Interventions
Background:
- Peripheral intravenous (IV) access is a frequent pediatric procedure with variable outcomes.
- Optimal strategies for maintaining IV catheter patency and minimizing complications remain unclear.
Purpose of the Study:
- To evaluate the impact of heparin flushes and splints on peripheral IV catheter patency and complications in children.
- To identify factors influencing IV catheter longevity and adverse events in a pediatric population.
Main Methods:
- A prospective, randomized controlled trial involving 88 pediatric patients (neonates to 12 years).
- 377 peripheral IV cannulations were randomized to receive either heparin flushes (1:100 dilution) or splints.
- Data collected on catheter patency duration and complications; analyzed using univariate and multivariate methods.
Main Results:
- Heparin flushes and splints significantly increased peripheral IV catheter patency duration.
- Phlebitis incidence was higher in the heparin flush group.
- Younger age, wrist/scalp insertion sites, and 24-gauge catheters were associated with shorter patency and more complications.
Conclusions:
- Heparin flushes and splints are effective in prolonging pediatric peripheral IV catheter patency.
- Careful consideration of patient age, insertion site, and catheter size is crucial for optimizing vascular access.
- The increased risk of phlebitis with heparin flushes warrants further investigation.
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