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Central venous Access device SeCurement And Dressing Effectiveness (CASCADE) in paediatrics: protocol for pilot

Amanda J Ullman1, Tricia Kleidon2, Victoria Gibson3

  • 1School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Nathan, Queensland, Australia Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Nathan, Queensland, Australia.

BMJ Open
|June 5, 2016
PubMed

Insights

This study assesses the feasibility of a large trial on paediatric central venous access device (CVAD) securement and dressing methods. Findings will inform future efficacy trials for reducing CVAD failure and complications in children.

Area of Science:

  • Pediatric medical devices
  • Clinical trial methodology
  • Infection control in healthcare

Background:

  • Paediatric central venous access devices (CVADs) have a high failure rate (25%).
  • Current securement and dressing methods may not be optimal.
  • Innovative technologies require evaluation for effectiveness across different CVAD types.

Purpose of the Study:

  • To evaluate the feasibility of a full-scale randomised controlled efficacy trial.
  • To assess CVAD securement and dressing strategies in paediatric patients.
  • To establish criteria for launching a definitive efficacy trial.

Main Methods:

  • Three feasibility randomised controlled trials at two Australian hospitals.
  • Comparison of current practice with sutureless securement, integrated dressings, and tissue adhesive.
  • Recruitment of 328 paediatric patients across three CVAD types: PICC, non-tunnelled CVAD, and tunnelled CVAD.

Main Results:

  • Primary outcomes focus on study feasibility: eligibility, recruitment, retention, attrition, data completeness, and satisfaction.
  • Secondary outcomes include CVAD failure and complication rates (infections, thrombosis, occlusion, dislodgement, breakage).
  • Effect sizes will be calculated to inform sample size for future efficacy trials.

Conclusions:

  • This research provides crucial feasibility data for a large-scale trial on paediatric CVAD management.
  • Findings will guide the selection of optimal securement and dressing strategies.
  • The study aims to reduce CVAD failure and associated complications in children.
Abstract

Keywords:
central venous catheterdressingevidence-based practiceprotocolsite care

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