(664) SecurAcath Device Safety and Efficacy in Pleural Tube Placement in Children

Introduction: Patients in the CICU may develop pneumothorax (PTX) or pleural effusion (PE). PTX or PE may require placement of a percutaneous chest tube (CT) to evacuate air or fluid in the pleural space. Historically, CTs are sutured to the skin. Migration and removal of CTs can occur inadvertently due to external forces. The securAcath device (SD) is a single-use securement device indicated for securement of percutaneous indwelling catheters/tubes and is in use at the Cook Children’s Medical Center (CCMC) CICU. We introduce a novel use for this SD in CT securement. This study aims to determine the effectiveness of the SD in CT securement by determining the incidence in catheter/tube dislodgement and migration. We compared the efficacy of SD to the typical suturing practice for patients admitted to the CICU at CCMC.

Methods: This is a retrospective cohort of patients undergoing CT placement while admitted to the CCMC CICU from March 1, 2018 to March 31, 2023. Patients under 18 years of age using SD or suture (ST) in CT placement while on admission were included. Initial screening for patient encounters yielded 176 subjects. 140 patients met inclusion/exclusion criteria with 204 CT insertions. Differences in duration of CT insertion between the SD group and ST group were analyzed by independent sample t-test for continuous data. Chi square test of independence was used to evaluate the association between dependent and independent variables. All statistical tests were two-sided. P-value of less than 0.05 was utilized as a cutoff for statistical significance.

Results: Two hundred and four 8.5 French chest tubes were inserted by intensivists in the CICU on 140 patients. There was no statistical difference in gender, diagnosis or type of congenital heart disease between the SD group and ST group. There was no significnce in the number of CTs inserted or the duration of the CTs between groups. No significance was found between groups with infection at the CT site or bleeding complications. The SD group was noted to have a lower incidence of inadvertant removal of the CT compared to the ST group.

Conclusions: The SD is as safe as suture securement in children in the CICU who require CT insertion. The SD demonstrates a lower incidence of inadvertent removal than ST securement of CTs in children in the CICU.