Tissue adhesives to secure peripheral intravenous catheters: A randomized controlled trial in patients over 65 years

Uğur Özkula; Ayhan Özhasenekler; Gülhan Kurtoğlu Çelik; Fatih Tanrıverdi; Gül Pamukçu Günaydın; Mehmet Ergin; Çağdaş Yıldırım; Şervan Gökhan

doi:10.1016/j.tjem.2018.08.003

Uğur Özkula¹, Ayhan Özhasenekler³, Gülhan Kurtoğlu Çelik³, Fatih Tanrıverdi³, Gül Pamukçu Günaydın², Mehmet Ergin³, Çağdaş Yıldırım³, Şervan Gökhan³

¹University of Kyrenia, Faculty of Medicine, Department of Emergency Medicine, Girne, KKTC, Cyprus
²Ankara Atatürk Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey
³Yıldırım Beyazıt University, Faculty of Medicine, Department of Emergency Medicine, Ankara, Turkey

Keywords: Peripheral catheterization tissue adhesive, Emergency department

Abstract

Introduction: Peripheral venous catheterization is one of the most used medical procedures in hospitals worldwide. Recent researches state that using intravascular devices is a risk factor for both local and systemic complications. In this study, we aimed to test that addition of tissue adhesive to the insertion site of peripheral intravenous catheters (PIVC) in the emergency department (ED) would reduce the device failure rate at 6 h and 24 h following insertion.

Material and methods: We designed a single-site, two-arm, randomized, controlled trial. We inserted 115 PIVCs into 115 adult patients.

Results: PIVC device failure for the 6th hour follow up was 15.4% in the tissue adhesive group (95% CI: 4.1–26.7) vs. 25.6% with standard care group (95% CI: 11.9–39.3). There was no statistically significant difference between two groups (p = 0.33).

The number of patients for 24 h follow-up was not enough and the obtained data could not be included in the study.

Discussion: In this study, the routine use of tissue adhesives in addition to standard care to reduce PIVC failure for patients 65 years or older in ED was not supported due to not clear benefits and cost effectivity.

Conclusion: Even though the routine use of tissue adhesives is not recommended according to the study results, it may be reasonable to use tissue adhesives for long term hospitalization expected patients to protect from related complications due to current literature.