Is cyanoacrylate fixation safe for neonatal IV access? A quality improvement evaluation of cyanoacrylate adhesive securement for short peripheral catheters

Reliable peripheral intravenous access is challenging in neonatal care due to frequent catheter failure. This quality improvement evaluation assessed the short-term safety and feasibility of cyanoacrylate fixation compared with conventional securement for short peripheral catheters in a neonatal intensive care unit. Over six months, 67 catheter insertions were observed (34 conventional, 33 cyanoacrylate). Dressing application time was similar between groups, and median dwell time was slightly longer with cyanoacrylate (68.1 h vs 64.0 h). Unplanned removal occurred in 76% of catheters, mainly due to infiltration or extravasation. No bleeding, skin injury, or dressing displacement was observed with cyanoacrylate fixation, and clinicians rated handling as easy or very easy in most cases. No statistically significant differences were identified. Infection outcomes were not evaluated. Cyanoacrylate fixation was feasible and not associated with local adverse events within this quality improvement setting. Further prospective studies are required to evaluate clinical effectiveness and infection-related outcomes.