Relevant Peripheral Intravenous Cannulation NEJM 2008 359 e26 – Blog Title

Peripheral intravenous (IV) cannulation is a common medical procedure used to deliver fluids, medications, or blood products directly into a patient’s vein. The New England Journal of Medicine published an influential study in 2008 (NEJM 2008 359 e26) that examined the best practices and outcomes associated with peripheral IV cannulation.


Intravenous therapy plays a vital role in modern healthcare, enabling quick and efficient delivery of various treatments. Peripheral IV cannulation is the most commonly used method, involving the insertion of a catheter into a peripheral vein, usually in the arm, hand, or wrist. This blog post explores the key findings and recommendations from the NEJM study.

Best Practices for Peripheral IV Cannulation

The NEJM study highlighted several key best practices for successful peripheral IV cannulation:

  1. Proper Site Selection: Choosing the appropriate vein and location is crucial. Veins in the upper extremities are preferred, with the median cubital vein being the first choice whenever possible.
  2. Correct Catheter Insertion Technique: Using aseptic technique and following the recommended insertion angle and depth are important to minimize complications.
  3. Securement and Dressing: Properly securing the catheter, along with using an occlusive dressing, reduces the chance of accidental removal or infection.

Complications and Prevention

While peripheral IV cannulation is generally safe, complications can occur. The NEJM study emphasized the following complications:

  • Infiltration: The inadvertent administration of fluids or medications into the surrounding tissue instead of the vein. To prevent infiltration, the cannula should be properly secured, and the site regularly monitored.
  • Phlebitis: Inflammation of the vein. Adequate flushing of the catheter, prompt removal of an unnecessary cannula, and proper dressing can help prevent phlebitis.
  • Infection: Catheter-related bloodstream infections are a serious concern. Strict adherence to aseptic technique and regular catheter site reviews can help reduce the risk of infection.

Recommendations from the NEJM Study

The NEJM study identified several important recommendations to improve peripheral IV cannulation practices:

  1. Educating Healthcare Providers: Proper training and education for healthcare providers involved in IV cannulation are essential to ensure adherence to best practices.
  2. Implementing Standardized Protocols: Establishing standardized protocols across healthcare facilities helps promote consistency and reduces the risk of errors.
  3. Using Ultrasound Guidance: The use of ultrasound for difficult cannulation cases can improve success rates and reduce complications.


In conclusion, the NEJM 2008 study on peripheral IV cannulation provides valuable insights into best practices, complications, and recommendations for healthcare professionals. By following the proper techniques outlined in the study, healthcare providers can enhance patient care and reduce complications associated with peripheral IV cannulation.

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