Abstract:
Background: Although widely used in clinical practice, long peripheral (LPCs) and midline catheters (MCs) are often misclassified because of their similar characteristics. Studies comparing complications associated to these devices are lacking. The study aim was to explore complications risks associated with polyurethane LPCs and MCs.
Methods: Prospective cohort study. All LPCs and MCs inserted during the study period were included. Catheter-failure within 30-days was the primary outcome, catheter-related bloodstream infection, thrombosis and fibroblastic sleeve were secondary outcomes. The average number of drugs infused per day was computed as a measure of the intensity of a catheter’s use throughout its indwelling time.
Results: The incidence of catheter-failure was 5.7 and 3.4/1000 catheter-days for LPCs and MCs, respectively. MCs were associated with an adjusted lower risk of catheter-failure (HR 0.311; 95% CI 0.106-0.917; p=0.034). The average number of drugs infused per day was higher for MCs (p<0.001) and was associated to a greater risk of catheter-failure (p=0.021). The bivariate sensitivity analysis showed a decreased risk for catheter failure for MCs only starting from the 10th day from catheter positioning. The incidence of catheter-related bloodstream infection (0.9 vs 0.0/1000 catheter-days), thrombosis (8.7 vs 3.5/1000 catheter-days) and fibroblastic sleeve (14.0 vs 8.1/1000 catheters-days) was higher for LPCs catheters.
Conclusions: Despite more intensive drug administration, MCs were associated with a longer uncomplicated indwelling time.
Reference:Fabiani A, Aversana N, Santoro M, Calandrino D, Liotta P, Sanson G. The Longer the Catheter, the Lower the Risk of Complications: Results of the HERITAGE Study Comparing Long Peripheral and Midline Catheters. Am J Infect Control. 2024 Jun 27:S0196-6553(24)00580-7. doi: 10.1016/j.ajic.2024.06.019. Epub ahead of print. PMID: 38944156.