Reducing Catheter Dislodgement in Pediatric Care: The SECURED Trial
Central venous catheters (CVCs) are a vital part of pediatric care, providing essential access for treatments in critically ill children. However, dislodgement of these catheters is a common issue, leading to complications and increased healthcare costs. To address this, the SECURED trial tested a new subcutaneous anchor securement system (SASS) against traditional sutureless securement devices (SSDs) to determine which method better prevents catheter dislodgement in children.
Study Overview
The SECURED trial was a multicenter, randomized clinical trial conducted in two pediatric hospitals in Australia. The study included 310 children aged 0 to 18 years who required noncuffed CVCs. These patients were randomly assigned to either receive the new SASS or the standard SSD securement method, with the goal of reducing catheter dislodgement over an 8-week period.
Key Findings
Dislodgement Rates: The trial found that CVC dislodgement was significantly lower in the SASS group, with only 5.2% of patients experiencing dislodgement, compared to 22.7% in the SSD group. This highlights the superior performance of the SASS method.
Complication Rates: Patients with SASS also experienced fewer complications during catheter use. Only 24.2% of the SASS group reported complications, compared to 39.0% in the SSD group.
Cost Efficiency: The SASS method was found to reduce healthcare costs by approximately A$36.60 (US $24.36) per patient, making it a cost-effective solution in addition to its clinical benefits.
Conclusion
The SECURED trial demonstrates that the SASS method significantly reduces the risk of CVC dislodgement and related complications in pediatric patients. While healthcare staff reported that SASS devices were more challenging to remove, the benefits of reduced dislodgement and complications, along with cost savings, make it a valuable alternative to traditional SSD methods.
Implications for Pediatric Care
Implementing the SASS system in pediatric hospitals could improve patient outcomes by minimizing catheter-related issues and lowering healthcare costs. This study sets the stage for further integration of this securement method into routine clinical practice.
Authors: Tricia M. Kleidon, Jessica Schults, Victoria Gibson, Derek J. Roebuck, Deborah Peirce, Ruth Royle, Robert S. Ware, Joshua Byrnes, Elizabeth Andresen, Paula Cattanach, Anna Dean, Colleen Pitt, Malanda Ramstedt, Craig A. McBride, Stephanie Hall, Claire M. Rickard, Amanda J. Ullman
