Assessment of the Incidence of Intravenous Cannula-associated Phlebitis Among Neonates in NICU, Nehru Hospital, PGIMER Chandīgarh

Background Neonates have small, fragile veins that are difficult to cannulate. Due to the underdeveloped skin structures and delicate veins, especially in preterm neonates, the risk of complications from venipuncture and intravenous infusions is higher. Inflammation of the vein’s tunica intima is known as phlebitis, and if it is not treated, it can cause an infection and thrombus formation. Early detection and appropriate interventions reduce the occurrence and severity of cannula-related phlebitis. Objective To assess the incidence of peripheral intravenous cannula-associated phlebitis among neonates. Materials and Methods This study was carried out among neonates with peripheral intravenous cannula admitted in the neonatal intensive care unit (NICU) of a tertiary care hospital in North India. The participant information sheet was given to the parents of neonates with a peripheral intravenous cannula, and those who provided written consent were enrolled on the day of cannula insertion using a consecutive sampling technique. A total of 87 neonates were enrolled on the day of intravenous cannula insertion, and the participant’s information sheet was filled by interview method. Data were collected by observation method using the Visual Infusion Phlebitis (VIP) scale for phlebitis and the Premature Infant Pain Scale (PIPS) for pain. Among them, 74 neonates had stage 2 and 3 phlebitis as per the VIP scale. Results The incidence of peripheral intravenous cannula-associated phlebitis was 94.25% among neonates. As per the VIP scale, stage 2 phlebitis developed in more than two-thirds (65.5%) of the neonates, 19.5% had stage 3 phlebitis, and 14.9% developed stage 1 phlebitis. The pain scores were mild (0–6) in 12.2%, moderate (6–12) in 58.1%, and severe (>above 13) in 29.7% of neonates. Conclusion The incidence of peripheral intravenous cannula-associated phlebitis among neonates was high and associated with moderate levels of pain.