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

Abstract

Background: Evidence-based insertion and maintenance strategies for neonatal vascular access devices (VAD) exist to reduce the causes of VAD failure and complications in neonates. Peripheral intravenous catheter failure and complications including, infiltration, extravasation, phlebitis, dislodgement with/without removal, and infection are majorly influenced by catheter securement methods. Methods: A retrospective, observational study using routinely collected data on intravenous device use in a large neonatal intensive care unit in Qatar. A 6-month historical cohort was compared with a 6-month cohort after the introduction of an octyl-butyl-cyanoacrylate glue (CG). In the historical cohort, the catheter was secured using a semi-permeable transparent membrane dressing while in the CG cohort, CG was applied at the insertion site on initial insertion and after any dressing change. This was the only variable intervention between both groups. Results: A total of 8330 peripheral catheters were inserted. All catheters were inserted and monitored by members of the NeoVAT team. 4457 (53.5%) were secured with just a semi-permeable transparent dressing and 3873 (46.5%) secured a semi-permeable transparent dressing with the addition of CG. The odds ratio for premature failure after securement with CG was 0.59 (0.54–0.65) when compared to the catheters secured with a semi-permeable transparent dressing, which was statistically significant ( p < 0.001). The correlation between the occurrence of a complication and the use of CG for device securement was significant ( p < 0.001). Conclusions: The risk of developing device-related phlebitis and premature device removal, increased significantly if CG was not used for adjunct catheter securement. In parallel with the currently published literature, this study’s findings support the use of CG for vascular device securement. When device securement and stabilization concerns are most pertinent CG is a safe and effective adjunct to reducing therapy failures in the neonatal patient population.

Increased risk of complications in lower versus upper limb peripheral intravenous cannulation in children with severe neurological impairment

“…Figure 1a,b displays the severity of these injuries, which both required ongoing medium term follow up. Prevention of extravasation injury includes careful PIVC site selection, secure dressings, use of catheter glue and regular site inspection (Gault, 1993;RCH Clinical Practice Guideline on Extravasation Injury Management, 2020;van Rens et al, 2023). Visual inspection and hospital-specific grading systems are currently used to identify extravasation injury; however, there are novel technological solutions being developed to detect extravasation injuries earlier, for example, various sensors monitoring impedance, temperature, radio-frequency and fluid pressure (Hirata et al, 2023).…”

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

“…Recently, engineered catheter securement devices and a CSCA have entered practice ( 1 , 2 , 15 , 23 – 29 ). Initially, these approaches were limited to central vascular catheter (CVC) securement but are now recommended as an adjunct for peripheral intravenous catheter (PIVC) securement ( 1 , 19 , 28 ). Currently, only one product, marketed as SecurePortIV® (Adhezion Biomedical, Wyomissing PA, USA), has Food and Drug Administration (FDA) and Certificate European (CE) approval for use in VA across all patient age groups and catheter types ( 1 , 2 , 20 ).…”