Effectiveness of tissue adhesive for vascular access devices in paediatrics: Systematic review and meta-analysis protocol

Abstract

Background: The securement of central venous access devices (CVADs) and peripheral catheters is critical in preventing complications and failure, particularly in paediatric patients. Tissue adhesive (TA) has emerged as a potential alternative to traditional securement practice. However, evidence regarding its effectiveness remains inconclusive. This protocol serves as a guide for conducting a systematic review and meta-analysis to address this gap. Aim: To assess the effectiveness of TA in comparison to other securement practices for securing CVADs and peripheral catheters in paediatric patients to prevent device complications and failure. Method: Following Cochrane Systematic Review guidelines, six databases and three clinical trials registries will be searched for randomized clinical trials in English, Spanish, and Portuguese, published from 2007 to 2024. Two independent reviewers will assess the articles, with a third resolving any conflicts. The population will include paediatric patients with CVADs or peripheral catheters secured with TA, compared to other securement practices. Pooled risk ratios and 95% confidence intervals will be reported, with separate analyses for CVADs and peripheral catheters. A revised Cochrane risk-of-bias tool for randomized trials (RoB2) will be used to assess data quality. Protocol registration: CRD42024558209. Conclusions: This protocol outlines the process for a systematic review and meta-analysis to assess the effectiveness of TA in securing CVADs and peripheral catheters in paediatric patients. By comparing TA to other securement practices, this protocol sets the foundation for advancing evidence in paediatric intravenous catheter securement, guiding future clinical practices and research.