Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study

English version

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
prolekare.web.journal.doi_sk: 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 – Physical sciences – Engineering and technology – Research and analysis methods – Mathematics – Probability theory – Medicine and health sciences – Materials science – Materials – Statistics – Mathematical and statistical techniques – Statistical methods – Agriculture – Animal products – Adhesives – Physics – Analysis of variance – Classical mechanics – Probability distribution – Normal distribution – Medical devices and equipment – Surgical and invasive medical procedures – Statistical data – Catheters – Leather – Catheterization – Compression

Zdroje

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