ABSTRACT
Background: Open peripheral intravenous (IV) catheters have been routinely used in neonates. Closed catheters have resulted in a longer indwelling time and reduction in catheter related complications such as phlebitis in adults. However, there is paucity of data in neonates.Methods: We conducted this pilot study in a pre-post study design. Open catheters were used in the first phase and closed catheters in the second phase. Hundred babies requiring intravenous fluid therapy for at least 24 hours in this neonatal intensive care unit were included in each group. Indwelling time and the complications leading to removal of the catheter were compared between the two groups.Results: Both groups were comparable in terms of gestational age, day of life, site of cannulation, nature of intravenous fluid and drugs administered. In the open catheter group, there was significant increase in use of inotropes (38% vs 22%; p=0.014) and blood products (16% vs 5%; p=0.011). The mean indwelling time (hours) was significantly greater in closed catheter group compared to open catheter group (47.1'19.4 vs 38.04'17.9; p <0.008). Inotrope use was found to decrease the indwelling time. There was an increase in indwelling time by 8.2 (SE 2.67) hours even after adjusting for use of inotropes. The incidence of catheter related complications was similar in both groups.Conclusions: There is a marginal but statistically significant increase in indwelling time when closed peripheral IV catheters are used in neonates. However, our results would be more meaningful if replicated in a larger randomized controlled trial.
ABSTRACT
To determine the effects of a single dose of dexamethasone on post-operative morbidity in patients undergoing tonsillectomy / adeno-tonsillectomy Prospective, randomized, placebo-controlled clinical trial Al-Sabah and Zain Ear, Nose, Throat Hospital, Kuwait Eighty patients [47 male and 33 female], aged between 5 and 18 years, undergoing tonsillectomy and/ or adenoidectomy. Patients were randomized to receive a single dose of intravenous dexamethasone or placebo [saline] Post-operative pain, nausea, vomiting and edema were the primary outcome measures. Fever, time taken to resume oral fluids, duration of hospital stay, frequency of re-admission, and time taken for complete healing of the tonsil bed were also compared between the two groups. Statistically significant differences were noted in pain scores, post-operative nausea and vomiting [PONV], tolerance to oral fluids, discharge from hospital, re-admission and wound healing between the two groups of patients. In this study, dexamethasone did not significantly exert any effect on fever in the first 24 hours in patients undergoing tonsillectomy. A single intra-operative dose of dexamethasone is an effective and safe method for reducing post-operative morbidity in tonsillectomy / adenotonsillectomy patients