CLABSI Prevention With Tissue Adhesive

Health-care associated infections (HAI) and especially central-line associated blood stream infections (CLABSI) are a well described burden in the intensive care units. There are two main possible pathways leading to central-venous line (CVL) related infection: the first is migration of microbes down the catheter tract (between the CVL and the skin), and the second is via the catheter hub/lumen. Cyanoacrylate adhesive is a commonly used tissue adhesive in children and adults with frequent use in pediatric facial lacerations. Several studies have shown its feasibility and safety in the general pediatric population, including neonates and in children after cardiac surgery.

To our knowledge, no study to date has explored the use of 2-octyl cyanoacrylate at central-line exit site as a mean to decreases pediatric CLABSI.

Our aim is to assess 2-octyl cyanoacrylate association with CLABSI rate in pediatric cardiac intensive care population.

Inclusion criteria

All patients admitted to pediatric cardiac ICU (PCICU) defined as high-risk for CLABSI (any of):

• young age<1y & Congenital Heart Surgery Mortality Category (STAT\\STS-EACTS) score 2-5
• Risk Adjustment for Congenital Heart Surgery (RACHS) category ≥3
• preoperative length-of-stay (LOS) >7 days
• preoperative ventilator support
• presence of a genetic abnormality
• extracorporeal membrane oxygenation (ECMO) support

Exclusion criteria

• Patients with on-going bacteremia
• patients with pre-existing central-line or peripherally inserted central catheter (PICC)
• parental refusal to participate.