Study identifies optimal catheter for pediatric IV medication administration

There is hope on the horizon for sick children requiring intravenous cannulation to administer medication. A randomized controlled trial led by Griffith University has provided evidence of the most effective type of catheter to use.

Led by Griffith University Ph.D. student Tricia Kleidon, the study was recently published in JAMA Pediatrics and compares peripheral intravenous catheters (which are short, thin tubes inserted into the upper and lower extremities) and central line catheters (which are a longer alternative and are inserted into a vein in the upper arm with the tip of the catheter ending just before the axillary or shoulder joint where there is increased flow blood). It’s titled “Central Line Versus Peripheral Intravenous Catheters for Four-Day or Longer Therapy in Pediatric Patients: A Randomized Clinical Trial.”

Professor Amanda Ullman, from Griffith’s Center of Research Excellence in Wiser Wound Care, said PIVCs often fail during treatment, causing interruptions in therapy, pain, re-catheterisation and other healthcare costs.

“Central line catheters can improve functional retention and reduce failure compared to traditional peripheral intravenous catheters,” Ullman said.

“A randomized clinical trial found that central line catheters failed significantly less often than peripheral intravenous catheters.”

“For children who received a peripheral intravenous catheter, 46% had catheters that failed, compared to only 16% of children who received central line catheters.”

The study also found that midline catheters were associated with fewer insertion attempts, longer length of stay, and lower healthcare costs. Importantly, patients and parents were more satisfied with them.

Kleidon said that when your patient is a sick child, the most important thing is to reduce their pain and distress.

“This study shows that in the future, when children are admitted to hospital, they are likely to have fewer needles and are more likely to receive uninterrupted treatment, meaning they are more likely to be discharged on time,” she said.

The randomized clinical trial ran from July 2020 to May 2022 and involved 128 patients from Queensland Children’s Hospital.

Patients who participated were between 1 and 18 years of age requiring peripherally compatible intravenous therapy for four days or longer.