The Intravenous Cannula for Newborn Infants Requiring Only Intravenous Medication

Abstract

In August 2003, the practice in the Royal Brisbane and Women's Hospital neonatal unit changed to the use of intermittent flushing of intravenous cannulas (instead of running a continuous infusion) for infants who only required an intravenous cannula for medications. In this historical cohort comparison study, the authors determined that the duration of cannula use and the numbers of cannulas needing removal were similar before and after the change. The authors conclude that the use of intermittent flushing for intravenous cannulas is a safe and viable alternative to continuous infusion for well term infants who only require intermittent intravenous antibiotics.

Continuous infusion versus intermittent flushing: maintaining peripheral intravenous access in newborn infants

“…Of these 115 newborns, 17 were excluded due to the following reasons: administration of parenteral nutrition via the cannula (7 subjects), transfer to another hospital (3), missing data (6) and the use of antibiotics other than amoxicillin and gentamicin (1). The study protocol is illustrated in Figure 1.…”

“…However, little evidence exists to indicate which method provides better results in newborns. [1][2][3][4][5] In our neonatal care unit, we routinely use continuous infusion of 5% dextrose at a rate of 3 ml h − 1 to maintain patency; this preference is based on the assumption that continuous infusion can prevent obstruction of the cannula, which can occur due to blood clots. 6 In contrast, others have argued that continuous infusion may cause irritation of the endothelium and can increase the risk of complications such as infiltration.…”

What Is Your KVO? Historical Perspectives, Review of Evidence, and a Survey About an Often Overlooked Nursing Practice

“…6 In the nursery, healthy infants who were on intermittent IV prophylactic antibiotics had their catheter infused with dextrose 10% at 1 mL/h between doses with the idea of keeping the vein open. Given that glucose-containing fluids are acidic and may damage endothelium resulting in phlebitis, 7 it was posited that intermittent flushing with normal saline might save nursing time and costs, and improve mother-baby bonding.…”

“…In neonates, the presence of IV tubing attached to the baby has been seen as a hindrance to mother-child bonding and the establishment of breast feeding. 6 With respect to cost and time, regular inspection of the IV site must be conducted by the nurse when a Review Committee in early 2014, after consultation with multiple stakeholders in critical care, anesthesia, nursing, and infection control. Recommendations were included ( Table 2 ).…”

Saline-Lock Versus Continuous Infusion: Maintaining Peripheral Intravenous Catheter Access in Children

“…Peripheral intravenous catheter (PIV) insertion is a necessary yet painful and invasive procedure performed on most children admitted to hospital. 1,2 Unfortunately, failure rates of PIVs have been reported to be as high as 69%. 3 Currently, there is a lack of evidence on how best to maintain PIV patency in children.…”