Comparison of midline catheters and peripherally inserted central catheters to reduce the need for general anesthesia in children with respiratory disease: A feasibility randomized controlled trial

Kleidon, Tricia; Schults, Jessica; Wainwright, Claire; Mihala, Gabor; Gibson, Victoria; Saiyed, Masnoon; Byrnes, Joshua; Cattanach, Paula; Macfarlane, Fiona; Graham, Nicolette; Shevill, Elizabeth; Ullman, Amanda

doi:10.1111/pan.14229

Cited by 14 publications

(38 citation statements)

References 40 publications

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“…Risk of bias assessment (Supporting Information: Table ) identified most studies as having a moderate to high risk of bias; most studies did not utilize random assignment. Only two studies, both randomized controlled trials, demonstrated a low risk of bias 21,22 . Per the GRADE criteria, the quality of the body of literature is low, based on high reliance on observational studies with an overall moderate risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…In all three studies, LPCs had a positive impact on patient/family experience. Two studies reported provider and staff experience with LPCs 21,33 . Carr et al 33 examined satisfaction in nursing staff, with an overall product rating of 4.4/5 on the basis of product quality, performance, ease of use, and education provided.…”

Section: Resultsmentioning

confidence: 99%

“…The rate of VTE was reported in six studies and ranged from 0% to 13%. 21,29,32,34,36,37 Rate of CRBSI was reported in 10 studies, and, except for one study, the rate was 0%. 21,25,27,28,[32][33][34][35][36][37] The one study that reported a rate of 3.5%…”

Section: Clinical Outcomesmentioning

confidence: 95%

“…Only two studies, both randomized controlled trials, demonstrated a low risk of bias. 21,22 Per the GRADE criteria, the quality of the body of literature is low, based on high reliance on observational studies with an overall moderate risk of bias. The inclusion of two randomized controlled trials helped offset the very low quality of observational studies with a high risk of bias.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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Long peripheral catheters in children: A scoping review

Burek

Liljestrom

Dundon

et al. 2022

Journal of Hospital Medicine

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Background and Objectives: Long peripheral catheters (LPCs) are emerging vascular access devices used for short-medium term vascular access needs. Literature in adults suggests LPCs have longer dwell-times than peripheral intravenous catheters (PIVs) and lower rates of serious complications than peripherally inserted central catheters (PICCs). The role of LPCs in children is less established. The objective of this scoping review is to describe and synthesize the existing literature on the effectiveness and safety of LPCs in children. Methods: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches were done in MEDLINE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, Scopus, CINAHL (Ebsco), and Google Scholar most recently on February 22, 2022. Studies were included if published in English on or after 2000 and included patients <18 years of age.Results: Twenty-one studies were included. The body of literature is variable in quality, measurements, and reported outcomes. Median dwell-time ranged from 5 to 14 days. The rate of completion of therapy ranged from 20% to 86%. Dislodgement, occlusion, and infiltration were the most common complications reported (0%-31%).Venous thromboembolism rates ranged from 0% to 13%. The rate of catheterrelated bloodstream infection was 0% in 9 of 10 studies. Less than 50% of studies reported comparative outcomes. Conclusion:LPCs show promising outcomes in select populations, with longer dwell-time than PIVs and possibly lower rates of serious complications than PICCs.However, more research is needed to clarify the optimal use of LPCs in pediatrics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 95%

Section: Description Of Included Studiesmentioning

confidence: 99%

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Long peripheral catheters in children: A scoping review

Burek

Liljestrom

Dundon

et al. 2022

Journal of Hospital Medicine

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“…Currently, intermittent intravenous antibiotic therapy is delivered via peripherally inserted central catheters (PICCs) 7,8 or midline catheters 9 when peripherally compatible infusion is planned for up to 4 weeks. Nowadays, long peripheral cannulas (LPC), defined (in adults) as devices longer than 6 cm and less than 15 cm, are an alternative intravenous device to administer short term peripherally compatible therapies.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound‐guided placement of long peripheral cannula in children with cystic fibrosis

Giardina

Barillà

Crimi³

et al. 2022

Pediatric Pulmonology

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Background The natural history of cystic fibrosis (CF) lung disease is a chronic deterioration of lung function with intermittent episodes of pulmonary infectious exacerbations (PExs). Reliable venous access is a milestone of effective management of such exacerbations, managed both in hospital and outpatient chronic therapy. The aim of our study was to analyze the feasibility of ultrasound‐guided positioning of long peripheral catheters (LPC) as reliable midterm venous access in children affected by CF. Methods In this single‐center prospective study, over a 60‐month period, we included paediatric CF subjects admitted with PExs and undergoing intravenous antibiotic treatment. LPCs were inserted in all participants by paediatric anaesthesiologists with ultrasound guide technique. Prospective data were collected assessing catheter positioning procedure and complications. Results A total of 122 LPC insertions were performed in 55 CF children. Participants had a median age of 6.75 years (interquatile range: 3.7−13.5) at the time of catheter insertion. Implantation was successful on the first attempt in 86% of cases; 2 (1%) major insertion‐related complications were reported. Eighty‐eight percent of catheters were electively removed at the end of antibiotic therapy without any complication. Seven percent of the catheters were removed electively for occlusion and 2% for local dislodgment. Conclusions The results of the present study suggest that ultrasound‐guided positioning of LPCs are safe alternative means of peripheral venous access in children with chronic diseases such as CF.

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Safety and Efficacy of Midline vs Peripherally Inserted Central Catheters Among Adults Receiving IV Therapy

Thomsen,

Boa,

Vinter-Jensen

et al. 2024

JAMA Netw Open

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ImportanceMidline catheters (MCs) are widely used, but safety and efficacy compared with peripherally inserted central catheters (PICCs) has not been adequately evaluated.ObjectiveTo compare the safety and efficacy of MCs with PICCs among adult patients with an anticipated intravenous therapy lasting from 5 to 28 days.Design, Setting, and ParticipantsThis parallel, 2-group, open-label, randomized clinical trial (RCT) was conducted in Denmark from October 2018 to February 2022 at a single academic tertiary care center. Adult inpatients and outpatients were consecutively randomized.InterventionPatients were randomized in a 1:1 ratio to either the MC group or the PICC control group.Main Outcomes and MeasuresThe primary outcome was catheter-related bloodstream infection (CRBSI), analyzed using the Fisher exact test. Secondary outcomes were symptomatic catheter-related thrombosis and catheter failure, including mechanical cause, phlebitis, infiltration, pain in relation to drug or fluid administration, and leaking from the puncture site. Incidence rate ratios (IRRs) were calculated to assess between-group failure rates over device dwell time using Poisson regression. An intention-to-treat analysis was performed.ResultsA total of 304 patients (mean [SD] age, 64.6 [13.5] years; 130 [42.8%] female) were included in the analysis, and 152 patients were allocated to each catheter group. The incidence of CRBSI was low, with 0 in the MC group and 1 in the PICC control group (P &gt; .99). The MC group had a higher catheter-related complication rate (20 [13.2%] vs 11 [7.2%]), and an IRR of 2.37 (95% CI, 1.12-5.02; P = .02) for complications compared with the PICC control group. In a post hoc analysis stratified by catheter dwell time, no significant difference in complication rate (IRR, 1.16; 95% CI, 0.50-2.68; P = .73) was found between the 2 groups for catheters used less than 16 days.Conclusions and RelevanceIn this RCT with patients who received medium- to long-term intravenous therapy, the incidence of CRBSI was low, with no difference between MCs and PICCs. The use of MCs resulted in a higher incidence of catheter-related complications compared with use of PICCs. This finding should be balanced in the decision of type of catheter used at the individual patient level.Trial RegistrationClinicalTrials.gov Identifier: NCT04140916

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Comparison of midline catheters and peripherally inserted central catheters to reduce the need for general anesthesia in children with respiratory disease: A feasibility randomized controlled trial

Cited by 14 publications

References 40 publications

Long peripheral catheters in children: A scoping review

Long peripheral catheters in children: A scoping review

Ultrasound‐guided placement of long peripheral cannula in children with cystic fibrosis

Safety and Efficacy of Midline vs Peripherally Inserted Central Catheters Among Adults Receiving IV Therapy

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