The Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI.
Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI.
Am J Infect Control. 2023 May;51(5):563-566. doi: 10.1016/j.ajic.2022.08.002. Epub 2022 Aug 7.
Midline catheters are recommended over peripherally inserted central catheters as short-term vascular access device for peripherally compatible infusates. We assessed the effectiveness and safety of midline catheters.
Data from midline catheter placements from June 2016 to May 2019 at a tertiary-care Veterans Administration medical center were retrospectively collected. Patients were followed until catheter removal or death, whichever occurred first. The primary outcome was completion of intended therapy; secondary outcomes were catheter-related complications, including major (eg, catheter-related bloodstream infections [CRBSI] or venous thromboembolism [VTE]) and minor (eg, catheter occlusion, kinking, dislodgement) events.
Of 115 midlines, 62 (53.9%) were for antibiotic infusion and 49 (32.6%) for difficult access. The median dwell time was 11 days (interquartile range, 5.5-19.5 days). Midline catheters lasted through completion of therapy in 93 patients (80.9%). Catheter-related complications occurred in 27 patients (23.5%), including catheter dislodgement in 10 patients (8.7%), catheter kinking in 8 (7.0%), and catheter occlusion in 3 (2.6%). Only 1 patient experienced a major complication, a deep venous thrombosis (0.9%).
Midlines appear to be effective and safe for short-term vascular access in patients requiring peripherally compatible infusates. While the rate of major complications is low, minor complications that necessitate device removal are common.
中置导管作为短期血管通路装置，推荐用于外周相容输液，优于外周插入的中心导管。我们评估了中置导管的有效性和安全性。
回顾性收集 2016 年 6 月至 2019 年 5 月在一家三级保健退伍军人事务部医疗中心进行的中置导管置管的数据。患者随访至导管拔除或死亡，以先发生者为准。主要结局为完成预期治疗；次要结局为导管相关并发症，包括主要（如导管相关性血流感染 [CRBSI]或静脉血栓栓塞 [VTE]）和次要（如导管阻塞、扭结、移位）事件。
在 115 根中置导管中，62 根（53.9%）用于输注抗生素，49 根（32.6%）用于难以置管。中位留置时间为 11 天（四分位距，5.5-19.5 天）。93 名患者（80.9%）的中置导管持续至治疗完成。27 名患者（23.5%）发生导管相关并发症，包括 10 名患者（8.7%）导管移位、8 名患者（7.0%）导管扭结和 3 名患者（2.6%）导管阻塞。只有 1 名患者发生严重并发症，即深静脉血栓形成（0.9%）。
中置导管似乎可有效且安全地用于需要外周相容输液的患者的短期血管通路。虽然主要并发症发生率较低，但需要移除器械的次要并发症很常见。
