Midline catheters: A 3-year experience at a veterans administration medical center

Johnson, Andrew G.; Gupta, Ashwin; Feierabend, Tristan; Lopus, Tracy; Schildhouse, Richard J; Paje, David

doi:10.1016/j.ajic.2022.08.002

Cited by 9 publications

(18 citation statements)

References 21 publications

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“…Compared to CVCs, midline catheters have lower risks of catheter related blood stream infection and thrombosis; the risk of thrombophlebitis is lower compared to peripheral catheters 10 . Cited rates for midlines include those of infection: 0.0%–0.3%; phlebitis: 0.3%–1.7%; infiltration or extravasation: 3.5%–10%; and occlusion: 2.6%–17.0% 11,12 . Other risks associated with midlines include erythema at the insertion site, bleeding, and pain 13 .…”

Section: Discussionmentioning

confidence: 99%

“…10 Cited rates for midlines include those of infection: 0.0%-0.3%; phlebitis: 0.3%-1.7%; infiltration or extravasation: 3.5%-10%; and occlusion: 2.6%-17.0%. 11,12 Other risks associated with midlines include erythema at the insertion site, bleeding, and pain. 13 These complications are spread over an average dwell time for midline catheters of 7.7-16.7 days, 10 which is longer than needed for stem cell collection.…”

Section: Logistical Issues Associated With Line Placementmentioning

confidence: 99%

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Peripheral blood stem cell collection: Are midline catheters a viable alternative to central venous catheters?

Tran,

Tajonera

2024

Transfusion

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BackgroundVascular access is a rate‐limiting step for peripheral blood stem cell collection. In the absence of readily accessible superficial veins, placement of tunnelled or non‐tunnelled central venous catheters (CVCs) is common. These invasive access routes create medical risks for patients and are associated with logistical challenges, thus prompting a search for alternatives. One such option is the off‐label use of midline catheters.Study design and methodsWe carried out a literature search for published experience with the use of midline catheters for peripheral blood stem cell collection. Data extracted included whether collections were allogeneic or autologous, donor sex, age and weight, inlet flow rate, total blood volumes (TBV) processed, collection duration, number of collections per donor, and achievement of collection targets.ResultsThe search produced three reports (one in abstract form) comprising 19 patients and 26 collection events. Donor sex and status were provided for 18 patients; 10 were female, 8 were male, 12 were allogeneic, and 6 autologous. Median (range) for: donor age was 28 (12–59); donor body weight (kg) was 77.5 (45.4–113.4); inlet flow rate (in mL/min) was 66 (28–80); TBV processed (in mL) was 15,880 (6178–21,871); collection duration (in hours) was 5.0 (3.2–7.0); and CD34 × 106/kg collection yield was 5.9 (3.6–23.0). Target CD34 yields were achieved in 14/19 (74%) of donors with 7/19 (37%) requiring two collections days.DiscussionPeripheral blood stem cell collection does appear to be viable via midline‐based catheter access, particularly for allogeneic donors and shorter collection courses. Development of institution‐specific guidelines and care pathways are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Logistical Issues Associated With Line Placementmentioning

confidence: 99%

Peripheral blood stem cell collection: Are midline catheters a viable alternative to central venous catheters?

Tran,

Tajonera

2024

Transfusion

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“…De estos CM se ha reportado éxito al final de la terapia intravascular del 80% del total de dispositivos instalados (21) , mientras que hay una reducción en los episodios de infección del torrente sanguíneo asociado a catéter de línea media versus dispositivos centrales insertados periféricamente (22) y mayor tiempo de permanencia en relación de catéteres periféricos cortos (23) . En este contexto de los dispositivos periféricos de línea media, en personas mayores se ha objetivado una tasa de éxito al final de terapia en 80,9% (24), mientras que en niños se ha reportado un 78% de retiro electivo al término de la terapia intravascular sin complicaciones (25) . En el área neonatal, un estudio chileno que implementó una técnica adaptada para instalación de catéter de línea media que objetivó el retiro electivo del dispositivo sin complicaciones en un 87,7% (26) .…”

Section: Introduccionunclassified

Cumplimiento De Practicas Clinicas Basadas en Evidencia Para La Instalacion Y Mantencion De Cateteres Venosos Perifericos en Personas Hospitalizadas

Ramírez Aguilera,

Vallejo Tabilo,

Maldonado Monroy

et al. 2024

Horiz Enferm

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El catéter venoso periférico (CVP) es un dispositivo ampliamente utilizado en el entorno clínico, a su vez presenta altas tasas de complicaciones. Se han definido estrategias basadas en evidencia para la instalación, como para la mantención. El objetivo del estudio fue describir la adherencia a las prácticas clínicas basadas en evidencia en la instalación y mantención del CVP disponibles en un hospital de alta complejidad. La investigación corresponde a un estudio observacional de corte transversal de los CVP disponibles en usuarios hospitalizados, a través de un formulario de recolección de información evaluado por enfermeros del equipo de acceso vascular. Se analizaron 225 CVP, el 85,3% correspondió a personas adultas, el 50,6% de los dispositivos lo portaban usuarios de servicios médico-quirúrgicos. El dispositivo más frecuente fue el catéter periférico tradicional cuantificado en 93,7%. Con relación a las prácticas de instalación, se objetivó que el 58,2 % contaba con fecha y hora de instalación, el 69,7% no tenía número de intentos y el calibre más utilizado a nivel global fue el 20 gauge; mientras que las prácticas de mantención, el 93,9% tenía apósito transparente semipermeable con sitio inserción visible, el 71,6% no tenía síntomas clínicos al momento de la valoración. La complicación más prevalente correspondió a presencia de restos de sangre en el 8,4 %, el 30% estuvo inactivo las últimas 24 horas y un 81,8% no contaba con registro de lavado pulsátil cada 12 horas. Los resultados concuerdan con estudios internacionales y latinoamericanos para la instalación y mantención de estos dispositivos.

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“…They become a role model for both students in training and other professionals in their daily practice [ 5 ]. For this reason, implementing evidence-based practices on a day-to-day basis improves satisfaction and service outcome indicators, including economic repercussions associated with cost reduction [ 6 , 7 , 8 , 9 , 10 ]. It also impacts patients’ quality of life [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Their rate of major complications is low, although minor complications necessitating device removal are common. As mentioned above, its use in specific conditions could reduce patient costs and risks [ 7 , 8 , 10 ]. The patient’s clinical status, the ongoing need for laboratory tests, and the intravenous therapy used should guide the selection of size, type, and placement of intravenous devices [ 8 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Midline Catheters versus Peripheral Venous Catheters in an Inpatient Unit: A Pilot Randomized Clinical Trial

et al. 2022

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Canalization of vascular accesses is one of the most used techniques in hospitalization units. When talking about peripherally inserted catheters, we can differentiate between peripheral intravenous catheters (PIVC), midline catheters, and long peripheral catheters (LPC). Midline catheters are rarely used despite being recommended for intravenous therapies lasting more than six days. This research is a pilot study of a longitudinal clinical trial. It aims to compare the complications associated with intravenous therapy between the control group (CG) with a PIVC and the experimental group (EG) with a midline in an Internal Medicine Unit of a Spanish hospital for three months. In this study, 44 subjects participated, 25 in the CG and 19 in the EG. The duration of cannulation was longer in the experimental group (8.13 days vs. 3.22, p < 0.001), and the appearance of phlebitis was more significant in the control group (19 patients in CG and 25 patients in EG). Midlines have presented a longer duration of cannulation and fewer complications than the PIVC. This protocol was registered with ClinicalTrials.gov (NCT05512117).

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Midline catheters: A 3-year experience at a veterans administration medical center

Cited by 9 publications

References 21 publications

Peripheral blood stem cell collection: Are midline catheters a viable alternative to central venous catheters?

Peripheral blood stem cell collection: Are midline catheters a viable alternative to central venous catheters?

Cumplimiento De Practicas Clinicas Basadas en Evidencia Para La Instalacion Y Mantencion De Cateteres Venosos Perifericos en Personas Hospitalizadas

Usefulness of Midline Catheters versus Peripheral Venous Catheters in an Inpatient Unit: A Pilot Randomized Clinical Trial

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