Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial.

Area of Science:

• Medical Devices
• Infection Prevention and Control
• Clinical Trials

Background:

• Peripheral intravenous catheters (PIVCs) are crucial for patient care but prone to failure.
• Standard securement methods, like polyurethane dressings, often fail prematurely.
• Effective PIVC securement is essential to prevent complications and ensure treatment continuity.

Purpose of the Study:

• To evaluate the efficacy of four distinct securement methods in preventing PIVC failure.
• To compare standard polyurethane dressing (SPU) with tissue adhesive (TA), bordered polyurethane dressing (BPU), and sutureless securement devices (SSD).

Main Methods:

• A single-centre, randomized controlled pilot trial involving 85 adult patients requiring PIVCs for ≥24 hours.
• Patients were allocated to SPU (control), TA+SPU, BPU, or SSD+SPU groups.
• Primary endpoint: PIVC failure, defined by premature removal due to pain, blockage, leakage, dislodgement, or infection.

Main Results:

• Catheter failure rates were lowest with tissue adhesive (14%), followed by SSD (22%), BPU (25%), and highest with standard SPU (38%).
• Tissue adhesive demonstrated the lowest adjusted hazard ratio for catheter failure (0.50).
• No local or catheter-related bloodstream infections were reported across all groups.

Conclusions:

• Standard polyurethane dressings alone are insufficient for preventing frequent PIVC failures.
• Tissue adhesive presents a promising, innovative approach to PIVC securement, though patient suitability requires consideration.
• Further large-scale trials are warranted to confirm these findings.