Goetz A M, Miller J, Wagener M M, Muder R R
VA Pittsburgh Health Care System, USA.
J Intraven Nurs. 1998 Mar-Apr;21(2):76-80.
The introduction of the Landmark midline catheter (Menlo, Co., CA) brought an alternative to central line catheter placement for prolonged intravenous access. The study was initiated in 1993 to observe for complications, including hypersensitivity-like reactions. The authors hypothesized this i.v. modality would decrease the need for central i.v. lines and accompanying complications. At the time of catheter insertion, the i.v. team nurses completed a survey form that included demographics, underlying disease, and risk factors for infection. The catheter tip was cultured at the time of removal. In the second phase of the study, the authors focused specifically on hypersensitivity-like reactions. During a 2-year period, 248 patients had 334 midline catheters. Patient ages ranged from 23 to 98 years (mean age, 65 years). The bacteremia rate was 0.3%; the colonization rate was 0.9%. Factors associated with infection/ colonization included: length of time in place, chemotherapy, and lack of antibiotic administration. In the second phase of the study, during which an additional 170 catheters were placed in 131 patients, no hypersensitivity-like reactions were noted. The midline catheter appears to be a safe method of i.v. fluid administration for patients with limited peripheral vein access who need extended i.v. therapy.
地标性中线导管（加利福尼亚州门洛公司）的引入为长期静脉通路提供了一种替代中心静脉导管置管的方法。该研究始于1993年，旨在观察并发症，包括类过敏反应。作者推测这种静脉输液方式将减少对中心静脉导管的需求及相关并发症。在导管插入时，静脉输液团队护士填写一份调查问卷，内容包括人口统计学信息、基础疾病和感染危险因素。在拔除导管时对导管尖端进行培养。在研究的第二阶段，作者特别关注类过敏反应。在两年期间，248例患者置入了334根中线导管。患者年龄范围为23至98岁（平均年龄65岁）。菌血症发生率为0.3%；定植率为0.9%。与感染/定植相关的因素包括：置管时间、化疗和未使用抗生素。在研究的第二阶段，又有131例患者置入了170根导管，未观察到类过敏反应。对于外周静脉通路有限且需要长期静脉治疗的患者，中线导管似乎是一种安全的静脉输液给药方法。
