None listed
Conditions
Brief summary
Central venous catheters (CVCs) placed in the internal jugular vein have been associated with increased risk of central line-associated infection and CVC failure compared to subclavian CVCs. Effective dressing and securement of internal jugular CVCs can reduce the risk of such complications, but dressing and securement is often inadequate due to 'drag' of infusion lines on the CVC and intermittent 'catching' of the CVC lines on other objects. Dressing failure also increases the risk of medical adhesive-related skin injury and central line-associated bloodstream infection due to repeated dressing changes. Mastisol Liquid Adhesive (MLA) is a non-water-soluble gum mastic liquid adhesive designed to improve dressing adherence and integrity. MLA has been shown to not increase bacterial growth and improve dressing adhesion in small studies, but has not been rigorously tested in a randomised controlled trial. The aim of this study is to investigate the effectiveness of MLA in reducing dressing changes, adverse events (e.g. device failure, infection and MARSI), clinician workload and costs associated with IJ CVCs. It is hypothesised that dressings secured with MLA will required changes less frequently, and therefore be associated with less adverse events, lower clinician workload and costs.
Interventions
Mastisol liquid adhesive (MLA) in addition to 'standard' central venous catheter dressing and securement products as per hospital policy. MLA will be applied to the skin around the CVC insertion site as per manufacturer’s instructions after skin decontamination and securement placement (if used) and before dressing application.
At each CVC dressing change, existing MLA will be removed using adhesive remover wipes and re-applied by the bedside nurse/clinician at every CVC dressing change for the
Mastisol liquid adhesive (MLA) in addition to 'standard' central venous catheter dressing and securement products as per hospital policy. MLA will be applied to the skin around the CVC insertion site as per manufacturer’s instructions after skin decontamination and securement placement (if used) and before dressing application. At each CVC dressing change, existing MLA will be removed using adhesive remover wipes and re-applied by the bedside nurse/clinician at every CVC dressing change for the duration of the CVC dwell. Participants and their dressings will be inspected daily by the research team to monitor dressing adherence and adverse events. In a subset of participants (convenience sample), skin swabs will be taken by research staff to assess skin flora at the CVC insertion sites at the time of CVC removal.
Sponsors
University of Queensland
Study design
Allocation
Randomised controlled trial
Primary purpose
Prevention
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• 18 years or over • Patient expected to require IJ CVC for greater or equal to 72 hours • Requiring greater or equal to 24 hours treatment in the ICU • Within 12 hours of CVC insertion
Exclusion criteria
• Emergency CVC insertion • Bloodstream infection in 24 hours prior to CVC insertion (as defined by National Health and Safety Network) • Pre-existing concurrent CVC expected to dwell for >24 hours • Patient receiving end-of-life care • Previous enrolment in this study
Outcome results
None listed