Splinting for Stabilizing Peripheral Intravenous Cannula in Neonates: A Randomized Controlled Trial

As many as 40-100% of the neonates admitted to a neonatal intensive care unit (NICU) require peripheral intravenous (PIV) cannulation, for varying reasons. Though unproven, splinting is conventionally thought to increase the lifespan of the cannula. The objective of this study was to determine whether standard fixation without splinting, after cannula insertion near a joint, influences its lifespan.

This unmasked, parallel group, randomized controlled trial was approved by the Hospital Ethics Committee. Eligible PIV cannula insertions were divided into: "No Splint" and "Splint" group. In the "Splint group" after standard fixation of the PIV, a readymade splint was used. Written informed consent was obtained from parents. The primary outcome was measured as difference in the lifespan of the PIV cannula in both the groups.

We enrolled 341 cannulations in "No Splint" and 344 in "Splint" group. The demographic details of both the groups were comparable. Mean gestational age, age at time of enrollment, and birthweight was 33+3 weeks, 3.4 days and 2,160 g, respectively. The mean (95% confidence interval) life of PIV cannula in the "No splint" and the "Splint" groups were 48.5 (45.1, 52.2) and 47.5 (43.6, 51.3) hours (p value 0.7), respectively. Subgroup analysis showed longer PIV cannula life in "No Splint" group neonates who were term and weighed ≥2,500 g.

In neonates with a PIV cannula placed over a joint, standard fixation without splinting did not shorten the cannula life. Not splinting may be associated with increased lifespan of the PIV cannula in term, normal birthweight neonates.