Dressings and Securement Devices of Peripheral Arterial Catheters in Intensive Care Units and Operating Theaters

Abstract

Background Hemodynamic monitoring, implemented by the placement of peripheral arterial catheters (PACs), is a characterizing aspect of the intensive care units. Peripheral arterial catheters can continually detect blood pressure and quickly conduct blood sampling. The use of PACs is generally considered safe, without serious complications. Currently, only 25% of the implanted catheters are actually subject to complications, including accidental removal, dislocation, occlusion, and infection. All of these complications arise from inadequate catheter stabilization at the level of the skin. This study aimed to summarize and describe the effectiveness and characteristics of dressings and securement devices for catheter stabilization. Methods A systematic review of literature from the following databases was conducted: MEDLINE, CINAHL, Cochrane, EMBASE, and OvidSP. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to guide article selection and reporting. Results Herein 626 articles were referred, with 5 directly related to the topic under discussion. We found 3 studies that describe PAC failure and 4 about dislodgement. We described 6 types of dressings or securement devices and classified them into 3 categories for classifying PAC dressings or securement devices. These were detected and grouped as adhesive tissues, sutureless devices, and transparent polyurethane dressings. Conclusions Current research indicates that transparent polyurethane dressings offer the most effective catheter stabilization, but adhesive tissues may constitute a valid alternative. However, there are limited high-quality studies about effective dressings and securement devices for PACs.

Complicanze emorragiche nell'assistenza infermieristica al paziente adulto in circolazione extracorporea: revisione della letteratura

“…Le strategie per prevenire il rischio di sanguinamento e delle possibili complicanze sono la parte più importante del processo di assistenza al paziente sottoposto a ECMO. Tutte le procedure invasive sono considerate ad alto rischio di sanguinamento: in letteratura viene raccomandato di utilizzare sempre la procedura con guida ecografica per il posizionamento dei cateteri vascolari e l'utilizzo di dispositivi sutureless per il fissaggio [23,24] . Per il fissaggio delle cannule del circuito extracorporeo è invece fondamentale ancorare le cannule agli arti inferiori (nel caso di incannulamento femoro-femorale) e medicare il sito di inserzione delle cannule con medicazioni trasparenti in poliuretano [25] .…”

10 best practice tips with radial arterial catheterization

“…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.…”

“…3 However, radial arterial catheter failure poses a significant issue for critical care clinicians 4 with reported incidences at almost 25%. 5 Common complications include loss of function, lack of blood return, poor quality waveforms and dislodgement, constituting potential patient risks, and sudden loss of intra-arterial monitoring frequently requires prompt replacement. 6 Contemporary research and technological improvements have highlighted several concepts to enhance the approach of RAC insertion and management while reducing immediate and late complications.…”

“…However, radial arterial catheter failure poses a significant issue for critical care clinicians 4 with reported incidences at almost 25%. 5 Common complications include loss of function, lack of blood return, poor quality waveforms and dislodgement, constituting potential patient risks, and sudden loss of intra-arterial monitoring frequently requires prompt replacement. 6…”

Pediatric robotic surgery: issues in management—expert consensus from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP)

“…Inadequate attachment can cause damage to the cannulated vessel wall, malfunction, erosion, inflammation, thrombosis, occlusion, and exit-site infections. Sutureless adhesive or subcutaneous fixation and anchoring systems are effective and safe [57][58][59], and there is no strong evidence to suggest that one system works better than another [57]. Central venous access, while not always necessary, can be useful and advantageous in pediatric RAS.…”