Abstract:
Objectives: We investigated whether an IV strategy based on new generation midline catheters was an efficacious alternative to a conventional IV strategy consisting of peripheral venous catheters and central venous catheters, for patients needing IV therapy exceeding five days.
Methods: This was a prospective, randomised, controlled study. Patients requiring more than five days IV treatment were randomised to either a midline catheter based IV strategy or a conventional strategy. The primary endpoint was composite of the insertion of a CVC or the need for ≥ four PVC insertions. The secondary outcomes included catheter dwell times and reasons for premature removal.
Results: 120 patients were included. In the midline group, the fraction of patients receiving ≥ four PVCs or had a CVC inserted was 12/58 (21%) vs. 38/58 (66%) in the conventional group (P < 0.001), number needed to treat: 2.2. Median overall catheter dwell times were 7 days (0-60 days) and 4 days (0-84 days) in the midline- and conventional groups, respectively (P = 0.002).
Conclusion: In patients requiring more than 5 days of IV therapy, a midline catheter strategy reduced the need for insertion of a CVC or more than 4 PVCs.
Trial registration: ClinicalTrials (NCT03457259).
Reference:
Nielsen EB, Antonsen L, Mensel C, Milandt N, Dalgaard LS, Illum BS, Arildsen H, Juhl-Olsen P. The efficacy of midline catheters – a prospective, randomised, active-controlled study. Int J Infect Dis. 2020 Oct 28:S1201-9712(20)32257-8. doi: 10.1016/j.ijid.2020.10.053. Epub ahead of print. PMID: 33129962.