Skin Glue to Reduce Intravenous Catheter Failure in Children - 10/01/25

Doi : 10.1016/j.annemergmed.2024.11.014

Owen Chauhan, MD ^a, Amy C. Plint, MD ^b,^c, Nick Barrowman, PhD ^c, Natasha Wills-Ibarra, RN ^c, Tyrus Crawford, BSc ^c, Mei Han, MSc ^c, Maala Bhatt, MD ^c,^d,^⁎
^a Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
^b Departments of Pediatrics and Emergency Medicine, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
^c Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
^d Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada

^∗Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 10 January 2025

Abstract

Study objective

The peripheral intravenous catheter (IV) is the most common and painful invasive medical device in acute care settings. Our objective was to determine whether adding skin glue to secure IVs reduced catheter failure rate in children.

Methods

We conducted a randomized controlled trial in a tertiary-care pediatric emergency department (ED). ED patients younger than 18 years old with an IV who were anticipated to be admitted to hospital were eligible for enrollment. Children were randomized to receive standard IV securement with cloth-bordered transparent polyurethane dressing (control) or application of cyanoacrylate glue at the catheter insertion site in addition to standard securement (intervention). Participants were followed until device removal due to failure or physician order. The primary outcome was IV failure before the intended treatment course was complete. Patients who were randomized with primary outcome data were included in the intention-to-treat analysis.

Results

Of the 557 participants enrolled between December 2020 and April 2023, 278 (50%) and 279 (50%) were allocated to the glue and control groups, respectively. A total of 527 participants were included in the intention-to-treat analysis. Intravenous failure rates in the glue and control groups were 83 of 265 (31.3%) and 82 of 262 (31.3%), respectively. The odds of intravenous catheter failure were not different between groups (adjusted odds ratio 0.98; 95% confidence interval, 0.67 to 1.42). Time to device failure was similar between groups (hazard ratio 0.99; 95% confidence interval, 0.73 to 1.35).

Conclusions

This study found no benefit in using skin glue to secure IVs in the ED in children.

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Keywords : Children < 18 years, Intravenous catheter, Equipment failure, Tissue adhesive

Plan

Introduction

Background

Importance

Goals of This Investigation

Methods

Study Design and Setting

Selection of Participants

Interventions

Randomization and Blinding

Characteristics of Study Subjects

Main Results

Limitations

Discussion

	Please see page XX for the Editor’s Capsule Summary of this article.
	Supervising editor: Lise E. Nigrovic, MD, MPH. Specific detailed information about possible conflicts of interest for individual editors is available at editors.
	Author contributions: OC, MB, and ACP developed the study concept and designed the trial, obtained funding, interpreted the data, and critically reviewed and revised the manuscript. OC and MB drafted the initial manuscript. NB designed the trial, conducted the data analysis, and critically reviewed and revised the manuscript. MH conducted the data analysis and critically reviewed and revised the manuscript. NW-I and TC coordinated and supervised data collection and critically reviewed and revised the manuscript for important intellectual content. MB takes responsibility for the paper as a whole.
	Data sharing statement: Deidentified individual participant data, data dictionaries, and analytic code will be made available on publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to Maala Bhatt, MD, at mbhatt@cheo.on.ca.
	Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
	Funding and support: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors do not have any such relationships to disclose. This study was funded by the Physicians’ Services Incorporated (PSI) Foundation #R19-36.
	Trial registration number: NCT04026906.
	Presentation information: Study results were presented at the 2023 European Society of Emergency Medicine, September 2023, Barcelona, Spain, and at the Pediatric Academic Societies Meeting, May 2024, Toronto, Canada.