Octyl-butyl cyanoacrylate glue versus splint for stabilising short peripheral intravenous catheters in neonates: a retrospective cohort study
Matheus FPT van Rens, Kevin Hugill, Robin van der Lee, Airene LV Francia, Fredericus HJ van Loon, Mohammad AA BayoumiAim
This study was conducted to compare the effectiveness of octyl-butyl cyanoacrylate glue or limb splinting used alone or in combination for stabilising neonatal short intravenous peripheral catheters (SPCs).
Materials and methods
This retrospective cohort study analysed routinely collected data from a tertiary neonatal intensive care unit. A total of 45 754 successfully inserted SPCs were grouped into one of three stabilisation strategies: splint+glue, splint only and glue alone. The primary outcome was SPC dislodgement. Secondary outcomes included dwell time, phlebitis, infiltration and extravasation. Multivariable logistic regression analysis was performed to adjust for potential confounders.
Results
Of the included SPCs, 1404 were stabilised using splint+glue, 12 006 using splint only and 32 344 using glue alone. In the unadjusted analysis, dislodgement differed between the groups (splint+glue, 1.5%; splint, 2.2%; glue, 2.6%; p=0.002). The median dwell time was the longest in the glue group (33.8 hours), although differences were not clinically significant. The incidence of phlebitis was the highest in the splint group (13.4%) compared with those in the glue (3.8%) and splint+glue (4.2%) groups (p<0.001). Kaplan–Meier survival analysis revealed statistically significant differences between the groups (p<0.001), with the splint+glue group exhibiting the highest catheter survival and the splint group the lowest. In multivariable analysis, the combined use of splint and glue was independently associated with reduced odds of dislodgement. Glue-based securement strategies were also associated with significantly lower odds of phlebitis compared with splint-only stabilisation.
Conclusion
Cyanoacrylate glue represents a safe and effective strategy for stabilising SPCs in neonates. Glue-based securement is associated with a substantially lower incidence of phlebitis and, when combined with splinting, may further reduce the risk of dislodgement. These findings support the integration of adhesive-based securement into neonatal vascular access practice.