Systematic Review of the Safety and Efficacy of Central Vascular Access Device Securement

Abstract

Central vascular access devices (CVADs) are essential for patient care in modern medicine. Providing access to the central circulation, CVADs allow fluids and medications to be infused rapidly and hemodiluted. The placement of a CVAD requires knowledge of vascular access devices, optimal site selection, infection prevention protocols, and expert techniques to limit potential adverse outcomes. Research has been focused on how to safely and effectively place CVADs, but little effort has been made to investigate the securement of the catheter once it is in place. This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered through PROSPERO. Two systematic searches of the literature were conducted, the first in January 2021 and the second in January 2022, by using multiple medical databases. Of the 1127 titles that met initial inclusion criteria 117 were selected for evaluation and then 39 for study. Search results yielded various outcomes, making a direct comparison between studies challenging. However, it was clear that safety and efficacy were not applied to suture-based securement and have not been well researched despite its general use. Randomized controlled studies are needed to measure the relative safety and efficacy of different securement modalities, their impact on CVAD complications, and ultimately patient outcomes.