None listed
Conditions
Brief summary
The insertion of an arterial catheter is a common intervention in the intensive care unit, allowing continuous haemodynamic monitoring as well as easy access for blood samples and blood gas analysis. Arterial catheterisation is recognised as being a safe procedure, with major complications such as arterial occlusion occurring in less than 1% of cases. Partial or complete dislodgement of arterial catheters, with the attendant risks of re-insertion such as infection and trauma remains an ongoing problem in the intensive care unit. Much effort has been made to improve the standard of securement, with studies focussing on alternative methods of fixation. The study will compare the rate of failure of arterial catheters secured with cyanoacrylate tissue adhesive (tissue glue) with those secured with traditional bordered polyurethane dressings. Dislodgement and subsequent failure of arterial lines is a relatively common problem in the intensive care unit, with associated costs for replacement in terms of staff time, equipment and consumables used and patient comfort. Arterial catheters will be randomised to receive either fixation with cyanoacrylate adhesive or traditional dressings. The primary outcome is the rate of failure of arterial catheters. The secondary outcome is skin reactions or injuries secondary to the fixation method used. The study population will be adult patients admitted to the SCGH ICU. The number of patients for this study will be calculated from the previous audit on arterial catheter failure rates. Inclusion criteria will be arterial catheters inserted in the radial artery. Exclusion criteria will be arterial catheters inserted into an artery other than the radial. Failure is defined as the inability to obtain an arterial waveform and subsequent pressure reading via the catheter, the inability to aspirate blood from the catheter or overt physical dislodgement of the catheter from the artery.
Interventions
Cyanoacrylate adhesive - n-butyl cyanoacrylate (Histoacryl, B Braun)
Adhesive is applied to the arterial catheter in order to secure it. Adhesive is applied on initial insertion and every three days thereafter. A maximum of 0.5ml of adhesive is to be used during any one application. The adhesive should be applied to the hub of the catheter and the entry site only.
Sponsors
Dr Tom Ryan
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Intensive care patients who require an arterial catheter to be inserted in the radial artery
Exclusion criteria
Intensive care patients who require an arterial catheter to be inserted in an artery other than the radial
Outcome results
None listed