Fixation of the short-term central venous catheter. A comparison of two techniques

Abstract

Fixation of the short-term central venous catheter. A comparison of two techniques 1Abstract Purpose: To compare the fixation of the central venous catheter (CVC) using two suture techniques. Methods: A clinical, analytical, interventional, longitudinal, prospective, controlled, singleblind and randomized study in adult, intensive care unit (ICU) patients. After admission and indication of CVC use, the patients were allocated to the Wing group (n = 35, catheter fixation with clamping wings and retainers) or Shoelace group (n = 35, catheter fixation using shoelace cross-tied sutures around the device). Displacement, kinking, fixation failure, hyperemia at the insertion site, purulent secretion, loss of the device, psychomotor agitation, mental confusion, and bacterial growth at the insertion site were evaluated. Results: Compared with the Wing group, the Shoelace group had a lower occurrence of catheter displacement (n=0 versus n =4; p = 0.04), kinking (n=0 versus n=8; p=0.001), and fixation failure (n=2 versus n=8; p=0.018). No significant difference was found in bacterial growth (n=20 versus n=14; p=0.267) between groups. Conclusion:The Shoelace fixation technique presented fewer adverse events than the Wing fixation technique.

Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study

“…The additional suturing of the segmentation site has been recommended to avoid dislodgement [6], even though this approach has not been evaluated systematically. A recent clinical study demonstrated that a combination of “clamp only” plus “finger trap” was superior to “clamp only” plus “fixation of the segmentation site” with regards to dislodgement rates and catheter kinking [17]. Our data support the assumption that fixation of the segmentation site increases the dislodgement force.…”

Complication and failures of central vascular access device in adult critical care settings

“…Studies originated in Europe (31; 49%) (31-61), North America (12; 19%) (8, 62-72), South America (5; 8%) (22,(73)(74)(75)(76), Oceania (6; 10%) (77-82), Asia (4; 6%) (83-86), and Middle East (5; 8%) (87-91). There were 24 RCTs (38%), 28 prospective (44%) and 11 retrospective studies (17%).…”

“…complications per 1,000 catheter days(22,34,36,49,55,56,63,64,67,72,76,82,85). Due to lack of consistency in outcome definitions, some study outcomes were eligible including: catheter dysfunction(34), CRBSI(73), kinking(76), fixation failure(74,76), displacement(76), infection(22,56), exudate(74), catheter related infection(57)(58)(59), catheter infection (56), local reaction(74). (95% CI 3-12; 4 studies; 1,481 CVADs) and highest pooled IR 11.2 (0-22.9) per 1,000 catheter days (3 studies; 8,809 catheter days).…”

Sternal Retraction and Subclavian Vein Catheter Occlusion during Cardiac Surgery

“…Infraclavicular subclavian vein (SV) catheterization may sometimes be used for this purpose in cardiac surgery. As the catheter usually stays in place for more than a week, it causes patient discomfort (especially after internal jugular vein catheterization) [1][2][3]. In addition to routine internal jugular vein catheterization, SV catheterization is sometimes used at Farshchian Cardiovascular Hospital, Hamadan, Iran.…”