Venous Catheterization
Conditions
Brief summary
A venous access device (VADs) is a biocompatible plastic catheter that establishes a connection between the skin surface and a venous system. They can be categorized using various classifications; notably, based on the position of the catheter tip, they are distinguished into central venous catheters (CVCs) and peripheral venous catheters (PVCs). Depending on their length, PVCs can be further divided into long-cannula PVCs and short-cannula PVCs. Currently, these catheters are stabilized "in situ" using transparent semipermeable dressings with a high moisture vapor transmission rate (MVTR), which keep the insertion site visible. Considering the pediatric patient population, this type of stabilization is currently somewhat archaic, and accidental displacement of PVCs is frequently encountered, along with subsequent complications such as extravasation, occlusion, phlebitis, and local infections. The addition of skin glue to the transparent semipermeable dressing ensures optimal stabilization of the device, reducing dislodgement, further complications, and consequently the need for multiple punctures for repositioning. Due to various clinical conditions, some patients presenting to the Emergency Department have a venous network that is difficult to identify by direct visualization or palpation. In these patients, the occurrence of an accidental displacement would significantly compromise the quality of care. Currently, there are no studies in the literature conducted in a pediatric emergency department that demonstrate the superiority of using cyanoacrylate glue for PVC stabilization compared to the semipermeable dressing alone. This study aim to investigate the use of cyanoacrylate glue for stabilizing venous access devices in the emergency setting as well, and to evaluate potential improvements to current daily clinical practice. The primary objective is to evaluate whether applying cyanoacrylate skin glue at the exit site provides better stabilization of a correctly placed peripheral venous catheter (PVC) compared to PVC stabilization with a transparent semipermeable dressing alone.
Interventions
PROCEDUREcyanoacrylate glue
Tissue adhesive to properly seal the venipuncture site and fix the catheter optimally to limit the risk of complications.
Sponsors
Meyer Children's Hospital IRCCS
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
0 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Age 0-18 years old * Venous access device for at least 24 hours. * Informed consent form signed
Exclusion criteria
* Patients with language barriers * patients with pre-existing central venous access * patients requiring immediate surgery with venous access placed under sedation * skin lesions in the affected area * patients exhibiting psychomotor agitation * patients assigned to the emergency code * unaccompanied minors
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of dislocations of the vascular access device (VADs) | 6 hours post- VADs insertion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of dislocations of the vascular access device (VADs) | 12, 24, 36, 48, and 72 hours post- VADs insertion | — |
| Change in Visual Exit Site (VES) score | 6, 12, 24, 36, 48, and 72 hours post- VADs insertion | Analysis of the frequency of complications |
| Correlation between the percentage of displacement of venous access device and DIVA score. | 6, 12, 24, 36, 48, and 72 hours post- VADs insertion | — |
Countries
Italy
Contacts
CONTACTGiulia Caccia, Principal Investigator
Outcome results
None listed