Skin Glue Versus Suture for Securing Radial Arterial Lines

NCT ID: NCT06589284

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-15

Study Completion Date

2024-06-14

Brief Summary

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Prior investigators have evaluated the use of 2-octyl cyanoacrylate (glue) as a method to secure a variety of venous catheters including central/peripheral lines. There is a paucity of research evaluating the use of glue for arterial catheters. The investigators conducted a pilot study to test the null hypothesis that there would be no difference in failure rates between radial arterial lines (r-a-line) secured with glue vs. suture.

Detailed Description

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This was a prospective, randomized, controlled, trial for which the investigators enrolled a convenience sample of consenting, non-pregnant, adult patients who received an r-a-line in the ICU or ED at a community-based, teaching hospital. After randomization, lines were secured with either silk 0-0 suture or 2-octyl cyanoacrylate and, then, covered by chlorhexidine gluconate dressing. Patients were followed for duration of line placement and for the occurrence of premature line failure. Categorical data were analyzed by chi-square; continuous data by t-tests.

Conditions

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Arterial Catheters Catheter Related Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients were randomized to line securement with either silk 0-0 suture or 2-octyl cyanoacrylate and, then, covered by chlorhexidine gluconate dressing.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Silk 0-0 suture covered by chlorhexidine gluconate dressing

The provider will be asked to use standard straight suturing technique followed by a tegaderm dressing for securing the radial arterial catheter.

Group Type OTHER

Silk 0-0 suture covered by chlorhexidine gluconate dressing

Intervention Type PROCEDURE

The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.

2-octyl cyanoacrylate covered by chlorhexidine gluconate dressing

The provider will be asked to use skin glue in a standardized fashion followed by a tegaderm dressing for securing the radial arterial catheter.

Group Type OTHER

2-octyl cyanoacrylate covered by chlorhexidine gluconate dressing

Intervention Type PROCEDURE

The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.

Interventions

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Silk 0-0 suture covered by chlorhexidine gluconate dressing

The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.

Intervention Type PROCEDURE

2-octyl cyanoacrylate covered by chlorhexidine gluconate dressing

The specific intervention will be securing radial arterial catheters with either skin adhesive or suture material. Both are largely accepted to be standard of care but to date there is a paucity of literature directly comparing the two for radial arterial lines. During the intervention the placement of radial arterial catheters will be done via standard sterile procedure and using seldinger technique which involves using a guidewire to slide the arterial catheter into the radial artery. After the catheter is placed, it will be secure with either straight suture with a cutting needle or via skin adhesive. Following securement, the area will be cleaned and a Tegaderm dressing with biopatch will be placed over the catheter. Data will be collected immediately after the procedure including length of procedure and complications as well as via chart review to determine the length of time the catheter was in place and evidence of premature failure.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Be at least 18 years of age
2. Require invasive blood pressure monitoring via radial arterial catheter

Exclusion Criteria

1. Under 18 years of age
2. Pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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CHRISTUS Health

OTHER

Sponsor Role lead

Responsible Party

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Peter Richman, MD

Professor and Research Director, Department of Emergency Medicine, CHRISTUS Health/Texas A&M College of Medicine, Residency in Emergency Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Peter Richman

Role: PRINCIPAL_INVESTIGATOR

CHRISTUS Health

Locations

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CHRISTUS Spohn Hospital Corpus Christi - Shoreline

Corpus Christi, Texas, United States

Site Status

Countries

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United States

References

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Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care. 2002 Jun;6(3):199-204. doi: 10.1186/cc1489. Epub 2002 Apr 18.

Reference Type BACKGROUND
PMID: 12133178 (View on PubMed)

Simonova G, Rickard CM, Dunster KR, Smyth DJ, McMillan D, Fraser JF. Cyanoacrylate tissue adhesives - effective securement technique for intravascular catheters: in vitro testing of safety and feasibility. Anaesth Intensive Care. 2012 May;40(3):460-6. doi: 10.1177/0310057X1204000311.

Reference Type BACKGROUND
PMID: 22577911 (View on PubMed)

Wilkinson JN, Sheikh N, Jayamaha J. Tissue adhesive as an alternative to sutures for securing central venous catheters. Anaesthesia. 2007 Sep;62(9):969-70. doi: 10.1111/j.1365-2044.2007.05240.x. No abstract available.

Reference Type BACKGROUND
PMID: 17697235 (View on PubMed)

Auyong DB, Cantor DA, Green C, Hanson NA. The Effect of Fixation Technique on Continuous Interscalene Nerve Block Catheter Success: A Randomized, Double-Blind Trial. Anesth Analg. 2017 Mar;124(3):959-965. doi: 10.1213/ANE.0000000000001811.

Reference Type BACKGROUND
PMID: 28151818 (View on PubMed)

Rickard CM, Marsh N, Webster J, Playford EG, McGrail MR, Larsen E, Keogh S, McMillan D, Whitty JA, Choudhury MA, Dunster KR, Reynolds H, Marshall A, Crilly J, Young J, Thom O, Gowardman J, Corley A, Fraser JF. Securing All intraVenous devices Effectively in hospitalised patients--the SAVE trial: study protocol for a multicentre randomised controlled trial. BMJ Open. 2015 Sep 23;5(9):e008689. doi: 10.1136/bmjopen-2015-008689.

Reference Type BACKGROUND
PMID: 26399574 (View on PubMed)

Bugden S, Shean K, Scott M, Mihala G, Clark S, Johnstone C, Fraser JF, Rickard CM. Skin Glue Reduces the Failure Rate of Emergency Department-Inserted Peripheral Intravenous Catheters: A Randomized Controlled Trial. Ann Emerg Med. 2016 Aug;68(2):196-201. doi: 10.1016/j.annemergmed.2015.11.026. Epub 2015 Dec 31.

Reference Type BACKGROUND
PMID: 26747220 (View on PubMed)

Reynolds H, Taraporewalla K, Tower M, Mihala G, Tuffaha HW, Fraser JF, Rickard CM. Novel technologies can provide effective dressing and securement for peripheral arterial catheters: A pilot randomised controlled trial in the operating theatre and the intensive care unit. Aust Crit Care. 2015 Aug;28(3):140-8. doi: 10.1016/j.aucc.2014.12.001. Epub 2015 Jan 9.

Reference Type BACKGROUND
PMID: 25583412 (View on PubMed)

Ozkula U, Ozhasenekler A, Kurtoglu Celik G, Tanriverdi F, Pamukcu Gunaydin G, Ergin M, Yildirim C, Gokhan S. Tissue adhesives to secure peripheral intravenous catheters: A randomized controlled trial in patients over 65 years. Turk J Emerg Med. 2018 Aug 23;19(1):12-15. doi: 10.1016/j.tjem.2018.08.003. eCollection 2019 Jan.

Reference Type BACKGROUND
PMID: 30793059 (View on PubMed)

Wilkinson JN, Chikhani M, Mortimer K, Gill SJ. The antimicrobial effect of Histoacryl skin adhesive. Anaesthesia. 2008 Dec;63(12):1382-4. doi: 10.1111/j.1365-2044.2008.05775.x. No abstract available.

Reference Type BACKGROUND
PMID: 19032320 (View on PubMed)

Wilkinson JN, Fitz-Henry J. Securing epidural catheters with Histoacryl glue. Anaesthesia. 2008 Mar;63(3):324. doi: 10.1111/j.1365-2044.2008.05468.x. No abstract available.

Reference Type BACKGROUND
PMID: 18289253 (View on PubMed)

Prachanpanich N, Morakul S, Kiatmongkolkul N. Effectiveness of securing central venous catheters with topical tissue adhesive in patients undergoing cardiac surgery: a randomized controlled pilot study. BMC Anesthesiol. 2021 Mar 8;21(1):70. doi: 10.1186/s12871-021-01282-0.

Reference Type BACKGROUND
PMID: 33685394 (View on PubMed)

King KC, Strony R. Needlestick. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK493147/

Reference Type BACKGROUND
PMID: 29630199 (View on PubMed)

Other Identifiers

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2022078

Identifier Type: -

Identifier Source: org_study_id

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