Ultrasound Guided Midline Catheter Insertion and Its Associated Complications in ICU Of Lahore General Hospital
DOI:
https://doi.org/10.36552/pjns.v28i4.1047Abstract
Objectives: A midline catheter is a vascular access device that is frequently used among patients requiring long-term medications. Along with its benefits, it holds some complications during insertion and use. So, with this study, we aimed to determine the associated complications during the insertion and use of midline catheters among patients admitted to the ICU of Lahore General Hospital.
Materials & Methods: A cross-sectional study was conducted in the ICU of Lahore General Hospital including 70 patients fulfilling the inclusion criteria and who required a midline catheter for further treatment. We recorded and analyzed the data of those patients, to whom we attempted to insert ultrasound-guided midline catheter. In this study, we observed the success rate of catheter insertion along with associated complications like hematoma, arterial puncture, occlusion of the catheter, dislodgement, edema, and thrombosis.
Results: Mean age of patients was 42.74 ± 10.48 years. The most common diagnosis at the time of catheter insertion was sepsis (52.9%). Median attempts for catheter insertion were 1 with (IQR 1 to 1, minimum 1; maximum 4). The success rate of the ultrasound-guided midline catheter insertion was 95.7%. Occlusion of catheters was frequently observed among 10.4% of patients. The arterial puncture was noted among four patients at the time of insertion. Thrombosis was observed in only one patient.
Conclusion: Ultrasound-guided midline catheter is beneficial and safe for ICU-admitted patients who need long-term treatment and use of Vasopressors.
References
Adams DZ, Little A, Vinsant C, Khandelwal S. The Midline Catheter: A Clinical Review. The Journal of Emergency Medicine. 2016;51(3):252-8.
DOI: 10.1016/j.jemermed.2016.05.029.
Chopra V, Kaatz S, Swaminathan L, Boldenow T, Snyder A, Burris R, et al. Variation in use and outcomes related to midline catheters: results from a multicentre pilot study. BMJ quality & safety. 2019;28(9):714-20. DOI:10.1136/bmjqs-2018-008554
DOI: https://doi.org/10.1136/bmjqs-2018-008554.
Griffiths V. Midline catheters: indications, complications and maintenance. Nursing standard (Royal College of Nursing (Great Britain) : 1987). 2007;22(11):48-57; quiz 8.
DOI: 10.7748/ns2007.11.22.11.48.c6241.
González López JL, Arribi Vilela A, Fernández del Palacio E, Olivares Corral J, Benedicto Martí C, Herrera Portal P. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. Journal of Hospital Infection. 2014;86(2):117-26.
DOI: 10.1016/j.jhin.2013.10.008.
Nielsen EB, Antonsen L, Mensel C, Milandt N, Dalgaard LS, Illum BS, et al. The efficacy of midline catheters—a prospective, randomized, active-controlled study. International Journal of Infectious Diseases. 2021;102:220-5.
DOI: 10.1016/j.ijid.2020.10.053.
Rajani A, Sayani R, Hamid RS, Salam B, Bilal MA. An Audit for Peripherally Inserted Central Catheter at Tertiary Care Center. PJR. 2016;20(2).
URL: http://www.pakjr.com/ojs/index.php/PJR/article/view/432.
Rickard CM, Marsh N, Webster J, Runnegar N, Larsen E, McGrail MR, et al. Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial. The Lancet. 2018;392(10145):419-30.
DOI: 10.1016/S0140-6736(18)31380-1.
Lakdawala YA, Fakhar SM, Khaled EA, Imtiaz A. Thrombophlebitis–incidence and risk factor evaluation. Pak J Surg. 2016;32(1):12-5.
Prasanna N, Yamane D, Haridasa N, Davison D,
Sparks A, Hawkins K. Safety and efficacy of vasopressor administration through midline catheters. Journal of critical care. 2021;61:1-4.
DOI: 10.1016/j.jcrc.2020.09.024.
Tripathi S, Kumar S, Kaushik SJCCM. The practice and complications of midline catheters: a systematic review. 2021;49(2):e140-e50.
DOI: 10.1097/CCM.0000000000004764.
Haider G, Kumar S, Salam B, Masood N, Jamal A, Rasheed YA. Determination of complication rate of PICC lines in oncological patients. Journal of the Pakistan Medical Association. 2009;59(10):663.
URL: https://ecommons.aku.edu/pakistan_fhs_mc_radiat_oncol/5.
Spiegel RJ, Eraso D, Leibner E, Thode H, Morley EJ, Weingart S. The Utility of Midline Intravenous Catheters in Critically Ill Emergency Department Patients. Annals of emergency medicine. 2020;75(4):538-45.
DOI: 10.1016/j.annemergmed.2019.09.018.
El-Shafey EM, Tammam TF. Ultrasonography-guided peripheral intravenous access: regular technique versus Seldinger technique in patients with difficult vascular access. European Journal of General Medicine. 2012;9(4):216-22.
DOI: 10.29333/ejgm/82434.
Meyer P, Cronier P, Rousseau H, Vicaut E, Choukroun G, Chergui K, et al. Difficult peripheral venous access: clinical evaluation of a catheter inserted with the Seldinger method under ultrasound guidance. Journal of critical care. 2014;29(5):823-7. DOI: 10.1016/j.jcrc.2014.04.022
Doi: https://doi.org/10.1016/j.jcrc.2014.04.022.
Scoppettuolo G, Pittiruti M, Pitoni S, Dolcetti L, Emoli A, Mitidieri A, et al. Ultrasound-guided "short" midline catheters for difficult venous access in the emergency department: a retrospective analysis. International journal of emergency medicine. 2016;9(1):3. DOI: 10.1186/s12245-016-0100-0.
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Copyright (c) 2024 Rehan Hassan Khan Niazi, Sara Khan Niazi, Anjana Kafle, Muhammad Saqib, Sidrah Batool, Muhammad Hassan Raza, Anum ZebThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
