# Endotracheal Tube Securement and Medical Device-Related Pressure Injury Incidence in the Intensive Care Unit: A Single-Center Retrospective Cohort Study

## TL;DR

A study found that using a specific device to secure endotracheal tubes in ICU patients reduced pressure injuries compared to traditional adhesive tape.

## Contribution

The study introduces evidence that AnchorFast SlimFit reduces MDRPIs compared to adhesive tape in ventilated ICU patients.

## Key findings

- AnchorFast use was associated with a significantly lower incidence of MDRPIs (15.3% vs. 32.3%).
- Lip-related MDRPIs were less frequent with AnchorFast (4.9% vs. 19.4%).
- Multivariate analysis confirmed AnchorFast as an independent protective factor against MDRPIs.

## Abstract

Background

Medical device-related pressure injuries (MDRPIs) are common among mechanically ventilated patients in the intensive care unit (ICU) and are frequently associated with endotracheal tubes. This study aimed to evaluate the association between different endotracheal tube securement methods and the occurrence of MDRPIs among mechanically ventilated patients.

Methodology

This single-center, retrospective cohort study was conducted at an advanced critical care and emergency center in Japan. Patients aged ≥16 years who required invasive mechanical ventilation for ≥48 hours between April 2020 and November 2024 were included. The AnchorFast SlimFit (Hollister) device was introduced in 2022 as an alternative to adhesive tape and routinely used since 2023. The incidence of MDRPIs (including intraoral sites) was compared between securement methods.

Results

A total of 364 patients were analyzed (AnchorFast group, n = 163; adhesive tape group, n = 201). The overall incidence of MDRPIs was significantly lower in the AnchorFast group than in the adhesive tape group (25/163 (15.3%) vs. 65/201 (32.3%), p < 0.001). Lip-related MDRPIs were less frequent in the AnchorFast group (8/163 (4.9%) vs. 39/201 (19.4%), p < 0.001). Multivariate logistic regression analysis identified AnchorFast use as an independent factor associated with a lower risk of MDRPIs occurrence (odds ratio = 0.522; 95% confidence interval = 0.033-0.626; p = 0.031).

Conclusions

AnchorFast fixation was associated with a markedly lower incidence of MDRPIs than conventional tape, particularly on the lips. Given the observational design, causal inference is limited, and prospective studies are warranted.