Özkula Uğur, Özhasenekler Ayhan, Kurtoğlu Çelik Gülhan, Tanrıverdi Fatih, Pamukçu Günaydın Gül, Ergin Mehmet, Yıldırım Çağdaş, Gökhan Şervan
University of Kyrenia, Faculty of Medicine, Department of Emergency Medicine, Girne, KKTC, Cyprus.
Yıldırım Beyazıt University, Faculty of Medicine, Department of Emergency Medicine, Ankara, Turkey.
Turk J Emerg Med. 2018 Aug 23;19(1):12-15. doi: 10.1016/j.tjem.2018.08.003. eCollection 2019 Jan.
Peripheral venous catheterization is one of the most used medical procedures in hospitals worldwide. Recent researches state that using intravascular devices is a risk factor for both local and systemic complications. In this study, we aimed to test that addition of tissue adhesive to the insertion site of peripheral intravenous catheters (PIVC) in the emergency department (ED) would reduce the device failure rate at 6 h and 24 h following insertion.
We designed a single-site, two-arm, randomized, controlled trial. We inserted 115 PIVCs into 115 adult patients.
PIVC device failure for the 6th hour follow up was 15.4% in the tissue adhesive group (95% CI: 4.1-26.7) vs. 25.6% with standard care group (95% CI: 11.9-39.3). There was no statistically significant difference between two groups (p = 0.33).The number of patients for 24 h follow-up was not enough and the obtained data could not be included in the study.
In this study, the routine use of tissue adhesives in addition to standard care to reduce PIVC failure for patients 65 years or older in ED was not supported due to not clear benefits and cost effectivity.
Even though the routine use of tissue adhesives is not recommended according to the study results, it may be reasonable to use tissue adhesives for long term hospitalization expected patients to protect from related complications due to current literature.
外周静脉置管是全球医院中最常用的医疗操作之一。近期研究表明，使用血管内装置是局部和全身并发症的危险因素。在本研究中，我们旨在测试在急诊科（ED）对外周静脉导管（PIVC）插入部位添加组织粘合剂是否会降低插入后6小时和24小时的装置故障率。
我们设计了一项单部位、双臂、随机对照试验。我们将115根PIVC插入115名成年患者体内。
组织粘合剂组在第6小时随访时PIVC装置故障率为15.4%（95%CI：4.1-26.7），而标准护理组为25.6%（95%CI：11.9-39.3）。两组之间无统计学显著差异（p=0.33）。24小时随访的患者数量不足，所获得的数据未纳入研究。
在本研究中，由于益处不明确和成本效益问题，不支持在标准护理基础上常规使用组织粘合剂来降低急诊科65岁及以上患者的PIVC故障率。
尽管根据研究结果不建议常规使用组织粘合剂，但根据当前文献，对于预期长期住院的患者使用组织粘合剂以预防相关并发症可能是合理的。
