Use of peripheral intravenous cannulas in premature infants: a controlled study

A randomized, controlled study was done to determine whether a 25-gauge steel needle or a 24-gauge Teflon catheter was preferable for the administration of peripheral intravenous fluids and medications to premature infants. A total of 58 cannulas--28 steel needles and 30 catheters--were used in 34 infants. The needles remained in place for 15.4 +/- 13.2 hours (mean +/- SD) and the Teflon catheters for 49.5 +/- 30.9 hours (mean +/- SD). All of the steel needles had to be removed because of infiltration whereas only 17/30 (57%) of the catheters infiltrated. A local inflammatory reaction, which was not related to infection, occurred with 11/30 (37%) of the Teflon catheters. Following removal, Staphylococcus epidermidis was grown from the culture of 1/19 steel needles and 1/25 catheters. In both instances this organism was thought to be a contaminant. Teflon catheters remain functional three times longer than steel needles with no apparent increase in complications. The use of these catheters, therefore, appears to be the preferred method for administering intravenous fluids to premature infants.