A randomised controlled trial to determine the effectiveness of a radial arterial catheter dressing

OBJECTIVE: To reduce radial arterial catheter failure in patients admitted to an adult intensive care unit (ICU). DESIGN: A randomised controlled trial. SETTING: A single site, large metropolitan tertiary referral public hospital. PARTICIPANTS: Three hundred participants admitted to an adult ICU were enrolled between 25 May and 13 September 2015. INTERVENTIONS: Participants were randomly assigned to one of two treatment groups (a polyurethane adhesive keyhole dressing or a polyurethane adhesive keyhole dressing together with a polyurethane semipermeable transparent dressing). MAIN OUTCOME MEASURE: Arterial catheter failure. RESULTS: Data were complete for 289 of the 300 adult participants, who were randomised to one of the two groups. There were 179 men (62%) with a median age of 61 years (IQR, 48-74). Overall, there were 109 arterial catheter failures (38%). There was a significantly higher catheter failure rate in the usual care group (65, 60%) compared with the intervention group (44, 40%; P = 0.05). Accidental catheter removal occurred in 87% of cases (n = 27) in the usual care group and in 13% of cases (n = 4) in the intervention group (P = 0.05). There was no significant difference between the two groups for time to catheter failure (P = 0.06). However, if patients were sedated, they were 54% less likely to experience arterial catheter failure (OR, 0.46; 95% CI, 0.31-0.67; P < 0.0001). CONCLUSION: This study showed a statistically significant reduction in arterial catheter failure using a radial arterial catheter dressing of a polyurethane adhesive keyhole dressing together with a polyurethane semipermeable transparent dressing. The nursing care technique of applying this dressing may improve dressing efficacy and patient safety and reduced costs.