Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study
Autoři:
Manuel Florian Struck aff001; Lars Friedrich aff001; Stefan Schleifenbaum aff002; Holger Kirsten aff003; Wolfram Schummer aff004; Bernd E. Winkler aff005
Působiště autorů:
Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany
aff001; ZESBO-Zentrum zur Erforschung der Stütz- und Bewegungsorgane, Leipzig, Germany
aff002; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
aff003; Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany
aff004; Department of Anesthesiology and Intensive Care Medicine, University Hospital Würzburg, Würzburg, Germany
aff005
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222463
Souhrn
Purpose
Proper fixation of central venous catheters (CVCs) is an integral part of safety to avoid dislodgement and malfunction. However, the effectiveness of different CVC securement sutures is unknown.
Methods
Analysis of maximum dislodgement forces for CVCs from three different manufacturers using four different suture techniques in an in vitro tensile loading experiment: 1. “clamp only”, 2. “clamp and compression suture”, 3. “finger trap” and 4. “complete”, i.e., “clamp + compression suture + finger trap”. Twenty-five tests were performed for each of the three CVC models and four securement suture techniques (n = 300 test runs).
Results
The primary cause of catheter dislodgement was sliding through the clamp in techniques 1 and 2. In contrast, rupture of the suture was the predominant cause for dislodgement in techniques 2 and 3. Median (IQR 25–75%) dislodgement forces were 26.0 (16.6) N in technique 1, 26.5 (18.8) N in technique 2, 76.7 (18.7) N in technique 3, and 84.8 (11.8) N in technique 4. Post-hoc analysis demonstrated significant differences (P < .001) between all pairwise combinations of techniques except technique 1 vs. 2 (P = .98).
Conclusions
“Finger trap” fixation at the segmentation site considerably increases forces required for dislodgement compared to clamp-based approaches.
Klíčová slova:
Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Catheters – Agriculture – Animal products – Leather – Engineering and technology – Medicine and health sciences – Surgical and invasive medical procedures – Catheterization – Physical sciences – Physics – Classical mechanics – Compression – Materials science – Materials – Adhesives – Mathematics – Statistics – Statistical data – Probability theory – Probability distribution – Normal distribution – Research and analysis methods – Mathematical and statistical techniques – Statistical methods – Analysis of variance
Zdroje
1. Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40: 1795–1815. doi: 10.1007/s00134-014-3525-z 25392034
2. Funcke S, Sander M, Goepfert MS, Groesdonk H, Heringlake M, Hirsch J, et al. Practice of hemodynamic monitoring and management in German, Austrian, and Swiss intensive care units: the multicenter cross-sectional ICU-CardioMan Study. Ann Intensive Care. 2016;6: 49. doi: 10.1186/s13613-016-0148-2 27246463
3. Frykholm P, Pikwer A, Hammarskjöld F, Larsson AT, Lindgren S, Lindwall R, et al. Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2014;58: 508–524. doi: 10.1111/aas.12295 24593804
4. Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21: 225. doi: 10.1186/s13054-017-1814-y 28844205
5. American Society of Anesthesiologists Task Force on Central Venous Access, Rupp SM, Apfelbaum JL, Blitt C, Caplan RA, Connis RT, et al. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2012;116: 539–553. doi: 10.1097/ALN.0b013e31823c9569 22307320
6. Valchanov K. Suturing central venous catheters. Br J Anaesth. 2017;118: 805–806.
7. Ullman AJ, Cooke ML, Mitchell M, Lin F, New K, Long DA, et al. Dressings and securement devices for central venous catheters (CVC). Cochrane Database Syst Rev. 2015;9: CD010367.
8. Rutledge LF, DeCabooter DP, Walters SA, Bernatchez SF. Catheter securement systems: comparison of two investigational devices to a sutureless securement device, a securement dressing, and sutures in a pig model. Intensive Care Med Exp. 2015;3: 60. doi: 10.1186/s40635-015-0060-3 26307415
9. Rickard CM, Edwards M, Spooner AJ, Mihala G, Marsh N, Best J, et al. A 4-arm randomized controlled pilot trial of innovative solutions for jugular central venous access device securement in 221 cardiac surgical patients. J Crit Care. 2016;36: 35–42. doi: 10.1016/j.jcrc.2016.06.006 27546745
10. Luo X, Guo Y, Yu H, Li S, Yin X. Effectiveness, safety and comfort of StatLock securement for peripherally-inserted central catheters: A systematic review and meta-analysis. Nurs Health Sci. 2017;19: 403–413. doi: 10.1111/nhs.12361 28730735
11. Karpanen TJ, Casey AL, Whitehouse T, Timsit JF, Mimoz O, Palomar M, et al. A clinical evaluation of two central venous catheter stabilization systems. Ann Intensive Care. 2019;9: 49. doi: 10.1186/s13613-019-0519-6 30997586
12. Sundararajan K, Wills S, Chacko B, Kanabar G, O'Connor S, Deane AM. Impact of delirium and suture-less securement on accidental vascular catheter removal in the ICU. Anaesth Intensive Care. 2014;42: 473–479. doi: 10.1177/0310057X1404200408 24967762
13. Lorente L, Huidobro MS, Martín MM, Jiménez A, Mora ML. Accidental catheter removal in critically ill patients: a prospective and observational study. Crit Care. 2004;8: R229–33. doi: 10.1186/cc2874 15312222
14. Moon J, Cho SU, Lee JW, Ryu S, Cho YC, Jeong WJ, et al. Usefulness of new method of central venous catheter securement using a continuous suture. Am J Emerg Med. 2017;35:961–963. doi: 10.1016/j.ajem.2017.01.063 28188058
15. Pittiruti M, Lamperti M. Late cardiac tamponade in adults secondary to tip position in the right atrium: an urban legend? A systematic review of the literature. J Cardiothorac Vasc Anesth. 2015;29: 491–495. doi: 10.1053/j.jvca.2014.05.020 25304887
16. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348: 1123–1133. doi: 10.1056/NEJMra011883 12646670
17. Leal MLM, Loyola ABAT, Hueb AC, Silva JDD Neto, Mesquita M Filho, Paiva LF, et al. Fixation of the short-term central venous catheter. A comparison of two techniques. Acta Cir Bras. 2017;32: 680–690. doi: 10.1590/s0102-865020170080000010 28902944
18. Vinjirayer A, Jefferson P, Ball DR. Securing central venous catheters: a comparison of sutures with staples. Emerg Med J. 2004;21: 582–583. doi: 10.1136/emj.2003.009860 15333537
19. Silich B, Chrobak P, Siu J, Schlichting A, Patel S, Yang J. Improving safety and efficiency during emergent central venous catheter placement with a needleless securing clamp. Emerg Med J. 2013;30: 683–686. doi: 10.1136/emermed-2011-200879 22962092
20. Motonaga GK, Lee KK, Kirsch JR. The efficacy of the arrow staple device for securing central venous catheters to human skin. Anesth Analg. 2004;99: 1436–1439. doi: 10.1213/01.ANE.0000132544.15467.10 15502044
21. Fazekas IG, Kósa F, Basch A. [On the tensile strength of skin in various body areas]. Dtsch Z Gesamte Gerichtl Med. 1968;64: 62–92. 5710955
Článek vyšel v časopise
PLOS One
2019 Číslo 9
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