Abstract:Vascular access specialists are responsible for assessing the patient in their unique situation and determining the correct vascular access device to complete the therapeutic goal without complication or failure. This retrospective cohort study compared the failure rates of a variety of polyurethane (PU) midline catheters and a midline catheter constructed of an emerging hydrophilic biomaterial (HBM). A total of 205 patients received a midline catheter and were situationally randomized by the facility where th… Show more
“… Fig. 1 Optical images of 2 µL water droplets on A thermoplastic polyurethane catheter, B HBM dehydrated catheter, and C HBM hydrated catheter [ 25 ] Fig. 2 SEM image of HMB surface, showing the surface morphology Fig.…”
Section: Discussionmentioning
confidence: 99%
“… Optical images of 2 µL water droplets on A thermoplastic polyurethane catheter, B HBM dehydrated catheter, and C HBM hydrated catheter [ 25 ] …”
Section: Discussionmentioning
confidence: 99%
“…Available clinical evidence is limited to one retrospective comparative clinical trial on MCs constructed of HBM versus a polyurethane base, conducted on 204 patient records that showed a significant reduction of catheter failures by 20.0%, including a 13% reduction in occlusions [ 25 ]. The existing research supports that increased hydrophilicity, reduces platelet adhesion, thrombus accumulation, and related complications.…”
Thrombotic accumulation is associated with surface interactions between blood proteins and vascular access devices. Catheter occlusion results from this process, and is a costly, common, occurrence with peripherally inserted central catheters (PICCs). Hydrophilic catheter materials exhibit antithrombotic properties. This retrospective study evaluates the occurrence of catheter occlusion of PICCs constructed of a poly(vinyl alcohol)-based hydrogel composite known as hydrophilic biomaterial (HBM), compared to thermoplastic polyurethane (TPU) control devices. A total of 121 PICCs, 60 HBM and 61 TPU, were placed in patients with a clinical need and were reviewed for the occurrence of catheter occlusion. The records review found that occlusions occurred in 0/60 (0.0%) of the HBM PICCs and 13/61 (21.3%) of TPU PICCs (p = 0.001). HBM exhibits favorable qualities for vascular access, most importantly its extreme hydrophilicity. Clinically, this may be responsible for the reduction in PICC occlusions, which could improve patient outcomes.
Graphical Abstract
“… Fig. 1 Optical images of 2 µL water droplets on A thermoplastic polyurethane catheter, B HBM dehydrated catheter, and C HBM hydrated catheter [ 25 ] Fig. 2 SEM image of HMB surface, showing the surface morphology Fig.…”
Section: Discussionmentioning
confidence: 99%
“… Optical images of 2 µL water droplets on A thermoplastic polyurethane catheter, B HBM dehydrated catheter, and C HBM hydrated catheter [ 25 ] …”
Section: Discussionmentioning
confidence: 99%
“…Available clinical evidence is limited to one retrospective comparative clinical trial on MCs constructed of HBM versus a polyurethane base, conducted on 204 patient records that showed a significant reduction of catheter failures by 20.0%, including a 13% reduction in occlusions [ 25 ]. The existing research supports that increased hydrophilicity, reduces platelet adhesion, thrombus accumulation, and related complications.…”
Thrombotic accumulation is associated with surface interactions between blood proteins and vascular access devices. Catheter occlusion results from this process, and is a costly, common, occurrence with peripherally inserted central catheters (PICCs). Hydrophilic catheter materials exhibit antithrombotic properties. This retrospective study evaluates the occurrence of catheter occlusion of PICCs constructed of a poly(vinyl alcohol)-based hydrogel composite known as hydrophilic biomaterial (HBM), compared to thermoplastic polyurethane (TPU) control devices. A total of 121 PICCs, 60 HBM and 61 TPU, were placed in patients with a clinical need and were reviewed for the occurrence of catheter occlusion. The records review found that occlusions occurred in 0/60 (0.0%) of the HBM PICCs and 13/61 (21.3%) of TPU PICCs (p = 0.001). HBM exhibits favorable qualities for vascular access, most importantly its extreme hydrophilicity. Clinically, this may be responsible for the reduction in PICC occlusions, which could improve patient outcomes.
Graphical Abstract
“…In the body response to foreign materials, blood and tissue proteins adsorption occurs within minutes of insertion of a venous catheter, polyurethane, or silicone, PICC or midline catheter, into the bloodstream and may inhibit the function of the catheter. Biocompatibility of the material, which may prevent a foreign body response, is most successfully achieved with hydrophilic material interface between the catheter surface and the tissue reaction making the material inherently inert and closely mimicking the blood chemistry [98]. Silicone catheters have a higher risk of microorganism colonization and infection, while polyurethane catheter risk of thrombosis and occlusion are higher, with neither demonstrating physical properties of lubricity or wettability with water absorption [95,99,100].…”
A literature review was conducted to evaluate the potential economic and clinical impact of hydrogel catheter materials on the incidence of catheter-related complications. Of 10,635 abstracts initially screened, 75 studies were included with 36 in outcomes, 28 for catheter materials, and 13 for economic analysis. The economic evaluation of peripherally inserted central catheters revealed a cost of $24,558 dollars for catheter-related thrombosis, $12,982 for infection, and $624 for occlusion which equate to a total national complication cost of $4.5 billion dollars annually. There was a 50% reduction in projected savings for all complications with the application of a hydrogel catheters which equated to nearly $1.8 million dollars annually for a typical 1000-bed acute care or $560,000 for a 300-bed facility. Limited clinical research on the hydrophilic catheter material suggests a remarkable and costeffective reduction for incidence of common catheter complications. More research is needed to confirm data from existing studies.
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