4 Saline-lock versus continuous infusion: maintaining peripheral intravenous catheter access in children. (19th August 2020)

• Record Type: Journal Article
• Authors: Yeung, Frances; Taheri, Sepideh; Miller, Michael; Ojha, Rahul; McKelvie, Brianna; Bock, Dirk; Poonai, Naveen; Cameron, Saoirse
• Is Part Of: Paediatrics & Child Health. Volume 25(2020)Supplement 2
• Page Start: e2
• Page End: e2
• Publication Date: 2020-08-19
• Subjects: Pediatrics -- Periodicals; Children -- Health and hygiene -- Periodicals; 618.92
• DOI: 10.1093/pch/pxaa068.003
• Languages: English
• ISSNs: 1205-7088

Abstract

Abstract: Background: Peripheral intravenous catheter (PIVC) insertion is a painful and invasive procedure performed on most paediatric patients. In children, PIVCs are maintained by either a continuous infusion of fluid "to keep vein open" (TKVO) or a saline-lock (SL). There is little uniformity between pediatric centres as to which method is used, and evidence is required to decide which method, if any, best maintains PIVC access. Objectives: The primary objective was to compare duration of functional PIVC patency between TKVO and SL in children. Secondary objectives included assessing PIVC-related complications and patient/caregiver satisfaction. Design/Methods: This prospective, time-allocated trial enrolled eligible patients from newborn to 17 years of age admitted to our pediatric ward. Patients enrolled in the first 3 months were assigned to TKVO, and patients in the latter 3 months were assigned to SL. Time of PIVC insertion and removal, PIVC-related complications, and satisfaction surveys were collected. Independent t-tests and chi-square tests were used to compare differences between arms for continuous and categorical outcomes, respectively. Results: Complete PIVC data was available on 172 (n=85 TKVO, n=87 SL) of 194 enrolled patients. The mean (SD) duration of PIVC patency was 41.68 (41.71) hours in the TKVO group, and 44.05 (41.46) hours in the SL group, which was not statistically significant (p=0.71). There were no significant differences in complication rates or overall patient/caregiver satisfaction between the two groups. One patient in the TKVO group had their PIVC removed due to risk of strangulation from tubing. Conclusion: There were no significant differences between TKVO and SL in the duration of PIVC patency in our pediatric population. This is consistent with previous results in neonates. There were also no significant differences in complication rates and overall patient/caregiver satisfaction. Overall, SL is a safe and reasonable alternative to TKVO in maintaining PIVC patency in children.