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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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domingo, 14 de febrero de 2016

Glue cannulas to patients?

A sticky solution for peripheral IVs
St. Emlyn´s - February 13, 2016 by Simon Carley
"Inserting a peripheral intravenous catheter (cannulas) into a patient seems part and parcel of their journey into hospital (Ed though perhaps it should not be). This intervention is most commonly started in our emergency departments. Yet just last year a Cochrane review was published showing that there is still no clear evidence to guide us in how best to keep them in place. Up to 69% of cannulas fail because of ineffective methods of securing them.
Hang on, are you telling me a cannula fails because of the way we stick it down?
Well, yes.
If a cannula is not secured well, it might make tiny movements. These movements could lead to the cannula becoming dislodged, irritation of the walls of the vein causing phlebitis, or the entry of micro-organisms, causing infection.


Bottom line 
Use of tissue adhesive in this trial does appear to reduce the incidence of cannula failure rate at 48 hours. This might be worth considering for patients likely to require admission of more than 48 hours’ duration, in order to reduce the anxiety of repeated cannula insertions for the patient. 
The key question is whether it will change your practice? We’re not sure on the basis of this single study, but we’d love to see some more research in this area. On the basis of this and other studies looking at glue placement of CVC lines it is certainly worthy of consideration."