The integrated short peripheral cannula: A new peripheral venous access device?

Abstract

Short peripheral intravenous cannulas have different features, as they may be winged or non-winged, ported or non-ported, equipped or not with needle stick prevention and “blood stop” mechanisms, and integrated or not with preassembled extensions or preassembled needle free connector. In the current range of commercially available short peripheral cannulas, there is one device that is apparently associated with several clinical advantages. In fact, short peripheral cannulas with safety mechanisms, closed system, winged, non-ported, and equipped with preassembled extension and preassembled needle-free connector appear to be associated with prolonged dwell time, reduction of the incidence of several complications (infiltration/extravasation, dislodgement, phlebitis, infection, blood leakage), cost reduction, and increased satisfaction of patients and clinicians. To clarify the current terminology and to identify this device for future clinical studies, the authors advocate the use of the term “integrated short peripheral cannula.” A rapid review of the current evidence suggests that this new device may have different clinical performance and different indications if compared to standard short peripheral cannulas. Though, the optimal clinical outcome can be achieved only when the device is inserted and maintained with proper protocols.

Comparing successful insertions, dwell time, reinsertions and the costs of supplies between integrated and simple short peripheral catheters

“…1 SSPCs (previously called “open system SPCs”) have no or minimal wing, with catheter usually made of polytetrafluoroethylene (PTFE), and without extension. 1,10 SSPCs require other components to complete the SPC circuit for use or maintenance; for example, a separate extension set to attach to the IV tubing for infusion or saline lock systems. 9 On the other hand, the new, more advanced ISPCs (previously named as “closed system SPCs”) are characterized by a closed system for blood control, safety mechanisms against accidental needlestick injury, catheter usually being made of polyurethane (which is less thrombogenic than PTFE), wing, preassembled extension, and preassembled needle-free connector.…”

“…9 On the other hand, the new, more advanced ISPCs (previously named as “closed system SPCs”) are characterized by a closed system for blood control, safety mechanisms against accidental needlestick injury, catheter usually being made of polyurethane (which is less thrombogenic than PTFE), wing, preassembled extension, and preassembled needle-free connector. 1,10…”

“…9,11,12 Whereas the expected dwell time of SSPC is only 2–3 days, an ISPC is expected to stay in place without untoward complication for 4–6 days. 1,10 Although the duration depends on various factors such as stabilization technique and dressing, the increased dwell time in ISPCs can be further explained by the presence of the preassembled extensions that permit the management of the infusion line without the unnecessary removal of the dressing. 10 Having longer duration for use, ISPCs yield economical savings or at least equal overall costs despite having more components, as found in the studies of González López et al 11 and Tamura et al 12 Additionally, another advantage of ISPCs is that their blood control mechanism reduces healthcare workers’ exposure to any blood leakage and contamination during insertion.…”

“…9 On the other hand, the new, more advanced ISPCs (previously named as "closed system SPCs") are characterized by a closed system for blood control, safety mechanisms against accidental needlestick injury, catheter usually being made of polyurethane (which is less thrombogenic than PTFE), wing, preassembled extension, and preassembled needle-free connector. 1,10 For over a decade, the comparisons between these SPCs have leaned towards the benefits of using ISPC than SSPC. Most previous reference studies found significantly longer dwell time, reduced rates of phlebitis, and unplanned reinsertions when using ISPCs.…”

“…1,10 Although the duration depends on various factors such as stabilization technique and dressing, the increased dwell time in ISPCs can be further explained by the presence of the preassembled extensions that permit the management of the infusion line without the unnecessary removal of the dressing. 10 Having longer duration for use, ISPCs yield economical savings or at least equal overall costs despite having more components, as found in the studies of González López et al 11 and Tamura et al 12 Additionally, another advantage of ISPCs is that their blood control mechanism reduces healthcare workers' exposure to any blood leakage and contamination during insertion. 9,[13][14][15] In terms of ease and success of insertions, other studies revealed that SSPCs were more likely to be inserted with fewer efforts due to the nurses' experience and familiarity with this traditional device 11 while others found no significant difference in terms of success rate or failed insertion attempts in either of the two catheter types.…”