• Clare Healy, Ian Baldwin, Judy Currey, and Andrea Driscoll.
• Department of Intensive Care, Alfred Health, Melbourne, VIC, Australia. clarel.healy@alfred.org.au.
• Crit Care Resusc. 2018 Mar 1; 20 (1): 61-67.

ObjectiveTo reduce radial arterial catheter failure in patients admitted to an adult intensive care unit (ICU).DesignA randomised controlled trial.SettingA single site, large metropolitan tertiary referral public hospital.ParticipantsThree hundred participants admitted to an adult ICU were enrolled between 25 May and 13 September 2015.InterventionsParticipants 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 MeasureArterial catheter failure.ResultsData 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).ConclusionThis 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.

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