Arterial Catheters, Catheter Related Complication
Conditions
Keywords
2-octyl cyanoacrylate, Central lines, Peripheral lines, Glue, Suture, Chlorhexidine gluconate dressing
Brief summary
Prior investigators have evaluated the use of 2-octyl cyanoacrylate (glue) as a method to secure a variety of venous catheters including central/peripheral lines. There is a paucity of research evaluating the use of glue for arterial catheters. The investigators conducted a pilot study to test the null hypothesis that there would be no difference in failure rates between radial arterial lines (r-a-line) secured with glue vs. suture.
Detailed description
This was a prospective, randomized, controlled, trial for which the investigators enrolled a convenience sample of consenting, non-pregnant, adult patients who received an r-a-line in the ICU or ED at a community-based, teaching hospital. After randomization, lines were secured with either silk 0-0 suture or 2-octyl cyanoacrylate and, then, covered by chlorhexidine gluconate dressing. Patients were followed for duration of line placement and for the occurrence of premature line failure. Categorical data were analyzed by chi-square; continuous data by t-tests.
Interventions
PROCEDURESilk 0-0 suture covered by chlorhexidine gluconate dressing
The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.
PROCEDURE2-octyl cyanoacrylate covered by chlorhexidine gluconate dressing
The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.
Sponsors
CHRISTUS Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Patients were randomized to line securement with either silk 0-0 suture or 2-octyl cyanoacrylate and, then, covered by chlorhexidine gluconate dressing.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Be at least 18 years of age 2. Require invasive blood pressure monitoring via radial arterial catheter
Exclusion criteria
1. Under 18 years of age 2. Pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of time which the catheter remained in place | 12 months | Primary outcomes measured were length of time of which the catheter remained in place and causes of premature failure, if it occurred. |
| Cause of premature failure (if occurred) | 12 months | Primary outcomes measured were length of time of which the catheter remained in place and causes of premature failure, if it occurred. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of patient demographics for line failure | 12 months | Secondary outcomes included an evaluation of patient and line placement demographics for line failure between both suture and skin glue groups. |
| Evaluation of line placement for line failure | 12 months | Secondary outcomes included an evaluation of patient and line placement demographics for line failure between both suture and skin glue groups. |
Countries
United States
Outcome results
None listed