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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

Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society
|May 23, 2008
PubMed

Insights

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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