A pilot randomised controlled trial of dressing and securement methods to prevent arterial catheter failure in intensive care

Thenar Compartment Syndrome Related to Tightened Radial Arterial Line During Robotic Laparoscopic Surgery: A Case Report

“…The best method for dressing and securing arterial catheters remains to be determined. 7 However, dressing and securement inadequacies may impact arterial catheter failure, such as poor waveform monitoring, inadvertent removal, partial/complete dislodgement, leaking, occlusion, limb ischemia, and catheter-related infections. 7,8 Connection of the tubing connector and catheter requires meticulous attention because complications, including hematoma, and bleeding could occur if the tubing is not tightly affixed and separates from the catheter hub.…”

“…7 However, dressing and securement inadequacies may impact arterial catheter failure, such as poor waveform monitoring, inadvertent removal, partial/complete dislodgement, leaking, occlusion, limb ischemia, and catheter-related infections. 7,8 Connection of the tubing connector and catheter requires meticulous attention because complications, including hematoma, and bleeding could occur if the tubing is not tightly affixed and separates from the catheter hub. 9 Although there are no recommended guidelines to secure the pressure tubing that is fastened to the catheter, the method of securing the tubing around the thumb has been demonstrated in photographs in previous reports.…”

“…9 Although there are no recommended guidelines to secure the pressure tubing that is fastened to the catheter, the method of securing the tubing around the thumb has been demonstrated in photographs in previous reports. 1,7,10 This method is used without notable problems in clinical practice. No studies express concerns for potential safety issues with this configuration.…”

10 best practice tips with radial arterial catheterization

“…Securing RACs with sutures is frequently associated with bleeding and ongoing need for repeated dressing changes, increased risk of infection, loss of access and needlestick injuries, and should be avoided whenever possible. 39,40 Cyanoacrylate tissue adhesives, widely used for skin wounds closure, provides effective securement for RAC and, in addition, an antimicrobial and hemostatic effect at the insertion site. 5,41 The combination of an engineered adhesive securement device (EASD), or sutureless, and transparent polyurethane dressing significantly prevents accidental catheter removal and dislodgement.…”

Insertion Site Dilemma: Rethinking Radial Arterial Catheter Placement for Device Resilience

“…We applaud the authors in stating that ultrasound permits the radial artery to be approached along its greater length in the forearm, improving overall insertion successes and efficiencies and reducing patient harm. While the study by Marie et al (1) reported a nonsignificance between both study groups, the prevalence of radial arterial catheter failure is reported to be as high as 25% (2,3). Despite the authors' claim of being the first study investigating the association between radial artery catheter position and failure reduction, other contemporary articles have already described these device-associated failures, including loss of catheter function, lack of blood return, compromised arterial waveform quality, and catheter dislodgement (4), with failures caused from accidental removal, device-associated occlusion or dislodgements, which directly impacts continuous monitoring and requires additional resources for replacement of the device (4-8).…”