Daniel J. Pallin, MD, MPH reviewing Bugden S et al. Ann Emerg Med 2015 Dec 31
Peripheral intravenous catheter failure is common and vexing. In a nonblinded randomized controlled trial of 380 IV catheter insertions in 360 adult patients, investigators compared failure rates between those who received cyanoacrylate glue — a drop at the catheter insertion site and a drop beneath the hub — and those who received standard care. The glue could be removed with commercially available cyanoacrylate-removal wipes.
At 48 hours, catheter failure — defined as occurrence of infection, phlebitis, occlusion, or dislodgement — occurred in 17% of the glue group versus 27% of the standard care group.
This single study may not be enough to change practice, but then again, it’s unclear whether a large multicenter study is likely to be done. Assuming that glue-removal wipes are available, it’s reasonable to start securing catheters with cyanoacrylate glue, and while you’re at it, make sure to use local anesthesia, too.
Bugden S et al. Skin glue reduces the failure rate of emergency department–inserted peripheral intravenous catheters: A randomized controlled trial. Ann Emerg Med 2015 Dec 31; [epub]. (http://dx.doi.org/10.1016/j.annemergmed.2015.11.026)