Effect of peripheral intravenous catheter type and material on therapy failure in a neonatal population

Abstract

Background: In neonatal settings vascular access devices are essential for treatment. However, their use is not without risks. The design and materials of peripheral vascular access devices have been evaluated amongst adult populations, but contemporary studies in neonatal settings are scant. Purpose/outcome measures: This research describes the prevalence of peripheral intravenous catheter failure related to three different catheter types with the intent to identify modifiable risks that might be used to evaluate device efficacy, innovate neonatal practice, and support future policy developments. Method and setting: This was a retrospective observational analysis of routinely collected anonymized intravenous therapy related data. The study was carried out at the tertiary neonatal intensive care unit (112 beds) of the Women’s Wellness and Research Center of Hamad Medical Corporation, Doha, Qatar. Participants: Neonates who were admitted to the unit requiring intravenous treatment wherefore peripheral intravenous cannulation was indicated, were included in this study. Results: The use of different type of catheters resulted in significantly less therapy failures as phlebitis and increased dwell time, compared with the control groups. This remains significant after adjusting for age at insertion, gestational age, birth weight, and catheter type. Conclusions: The study’s findings are in accord with international literature concerning adult and pediatric patients concerning the superiority of PUR over PTFE catheters with respect to the risk of phlebitis and longer dwell times. However, the risk of failure of therapy did not differ between catheters. This finding is reassuring and supports practitioner judgment when selecting peripheral catheter devices.

Octyl-butyl-cyanoacrylate glue for securement of peripheral intravenous catheters: A retrospective, observational study in the neonatal population

“…Premature VAD failure in the clinical setting is influenced by numerous unmodifiable patient characteristics and potentially modifiable factors and impacts upon patient experience, their well-being and outcomes, and hospital economics. 8,27 Appropriate securement of VADs is an essential component of effective infusion therapy and quality care. The strategies employed to ensure the securement of VADs have a crucial role in preventing the development of device-related failures, infusion-related complications and associated injuries within all patient populations.…”

“…2,[8][9][10][11][12] Our findings support the contention that applying CG to secure PIVCs is an effective intervention for the neonatal population and could be added to existing insertion care bundles. Several publications have recently evaluated outcomes along with the use of CG for both peripherally and centrally inserted central catheters (PICC/CICC) with various securement methods, [16][17][18][27][28][29][30] outlining the noteworthiness and clinical impact CG has in preventing device-related failures and loss of venous access, corroborating it is safe and effective with regular use. Cyanoacrylates are well established as being very biocompatible and their ability to undergo polymerization with moisture allows for better bonding to the skin.…”

Safe and effective removal of cyanoacrylate vascular access catheter securement adhesive in neonates

“…They provide effective securement, reduce catheter migration, the risk of accidental removal, and decrease the need for frequent dressing changes ( 15 , 23 ). Furthermore, CSCAs inhibit bacterial and fungal growth, with evidence supporting reductions in the risk of acquiring catheter-associated infection ( 1 , 2 , 5 , 15 , 24 , 27 – 30 ). Standards and guidelines for catheter securement recommend that CSCA, used alone or combined with tapes, other securement devices, and the primary transparent dressing can reduce VA-related complications ( 1 , 2 , 19 , 26 , 31 ).…”

“…Over recent years, evidence-based practice innovations, such as care bundles, and intravenous (IV) team approaches have become firmly embedded in neonatal vascular access (VA) practice ( 1 – 4 ). These developments have taken place alongside technological improvements in the design and manufacture of VA devices and catheters for neonatal patient populations, with the intent of reducing VA-related complications ( 5 , 6 ). Despite these advances, the incidence of VA-related complications remains unacceptably high, and dwell times for VA catheters, particularly peripheral IV catheters (PIVC) among this patient group, are generally considered to be suboptimal ( 6 , 7 ).…”