Use of cyanoacrylate glue for the sutureless securement of epicutaneo-caval catheters in neonates

Abstract

Introduction: Epicutaneo-caval catheters (ECC) are pivotal for drug and fluid infusion in neonates. Given the intrinsic importance of the catheter for the patients’ health and the need to avoid stressful and painful procedures on premature or critically ill newborns with fragile and poor vein asset, it is clearly necessary an accurate bundle for ECC insertion and management to avoid complications that may lead to non-elective ECC removal. Among others, dislodgment is an acknowledged complication, and conventionally adopted fixing devices seem alone unsatisfying in relation to ECC securement. Object: To evaluate the usefulness of medical Cyanoacrylate Glue (CG) as a solution to strengthen conventional ECC securement. Methods: Since the use of CG has become part of our ECC insertion bundle in 2018, the present study compares all term and preterm neonates admitted in our NICU in 2018 who required an ECC for any cause (92 cases) with an historical cohort formed by all neonates who required an ECC in 2017 (80 patients). Results: CG added to usual securement devices is effective in reducing ECC accidental dislodgment. Moreover, it is easy and safe to apply and remove, limits bleeding and oozing at the puncture site, and may also be an effective antimicrobial mechanical barrier.

Tamponade and massive pleural effusions secondary to peripherally inserted central catheter in neonates–A complication to be aware of

“…The use of medical cyanoacrylate glue is proposed to be superior to conventional dressing in reducing the incidence of catheter dislocation (31). Also, we suggest that at any time, should a chest radiograph be performed for any clinical purpose, the neonatal Displacement of PICC inserted through the Basilic vein during arm movement.…”

A Revolutionary, Proven Solution to Vascular Access Concerns: A Review of the Advantageous Properties and Benefits of Catheter Securement Cyanoacrylate Adhesives

“…Because of their safety, biocompatibility, effectiveness, flexibility, and better cosmetic effect, the use of CSCAs in neonatal and pediatric populations has recently gained increasingly more attention of clinicians and health care providers. In 2021, D'Andrea et al52 published the use of cyanoacrylate TAs for the sutureless securement of epicutaneo-caval catheters in neonates. The study concluded that the addition of CSCAs to conventional securement methods was effective in reducing accidental dislodgement of epicutaneo-caval catheters and limiting bleeding and oozing at the puncture site and that CSCAs were easy and safe to use, which may be an effective antimicrobial mechanical barrier 52.…”

“…In 2021, D'Andrea et al52 published the use of cyanoacrylate TAs for the sutureless securement of epicutaneo-caval catheters in neonates. The study concluded that the addition of CSCAs to conventional securement methods was effective in reducing accidental dislodgement of epicutaneo-caval catheters and limiting bleeding and oozing at the puncture site and that CSCAs were easy and safe to use, which may be an effective antimicrobial mechanical barrier 52. In order to minimize CR-BSIs in critically ill children, Biasucci et al44 evaluated the effectiveness of a bundle that includes use of CSCAs to seal and protect catheter incision sites and demonstrated a decrease in CR-BSI rate.…”

“…The study concluded that the addition of CSCAs to conventional securement methods was effective in reducing accidental dislodgement of epicutaneo-caval catheters and limiting bleeding and oozing at the puncture site and that CSCAs were easy and safe to use, which may be an effective antimicrobial mechanical barrier. 52 In order to minimize CR-BSIs in critically ill children, Biasucci et al 44 evaluated the effectiveness of a bundle that includes use of CSCAs to seal and protect catheter incision sites and demonstrated a decrease in CR-BSI rate. Pittiruti 53 described a retrospective study using a wireless device for intracavitary electrocardiogram in 85 children, with the lowest weight patient being 1100 g. All procedures included securement of the catheter by cyanoacrylate glue, sutureless device, and transparent dressing.…”

Cyanoacrylate Securement in Neonatal PICC Use

“…The FDA has stated that TA may be used safely with both infants and premature neonates, and also with chlorhexidine-sensitive patients. The benefit is that the adhesive can be applied to a very small surface area, in addition to that occupied by the catheter, allowing for fine adjustments of the catheter in any securement position 22–25. During the time of dressing changes and/or device removal, a silicone-based adhesive remover is used to prevent unwanted medical adhesive-related skin injuries (MARSIs).…”