The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective, observational study

Sharp, Rebecca, Esterman, Adrian, McCutcheon, Helen, Hearse, Neville and Cummings, Melita (2014) The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective, observational study. International Journal of Nursing Studies, 51 5: 694-702. doi:10.1016/j.ijnurstu.2013.09.002


Author Sharp, Rebecca
Esterman, Adrian
McCutcheon, Helen
Hearse, Neville
Cummings, Melita
Title The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective, observational study
Journal name International Journal of Nursing Studies   Check publisher's open access policy
ISSN 0020-7489
1873-491X
Publication date 2014-05-01
Sub-type Article (original research)
DOI 10.1016/j.ijnurstu.2013.09.002
Open Access Status Not Open Access
Volume 51
Issue 5
Start page 694
End page 702
Total pages 9
Place of publication Bromley, United Kingdom
Publisher Elsevier
Language eng
Formatted abstract
Background

Intravenous antibiotics are the cornerstone of treatment for patients with cystic fibrosis (CF). Midlines are a type of vascular access device (VAD) used exclusively in one treatment facility within Australia, most other centres use peripherally inserted central catheters (PICCs).

Objective

To ascertain the safety and efficacy of midlines for CF patients receiving intravenous antibiotics.

Design

Retrospective observational.

Setting

A large, major metropolitan teaching hospital in Adelaide, South Australia.

Participants

Adult patients with a diagnosis of CF, who had a PICC or midline inserted for the commencement of antibiotic therapy during the period 2004–2010 to treat a respiratory exacerbation.

Methods

Medical records and hospital reports were used to record rates of adverse events and unexpected removal of VADs. The primary outcome was a composite measure of adverse events (catheter-related blood stream infection, deep vein thrombosis, occlusion, pain, infiltration, bleeding, phlebitis, catheter leakage and dislodgement) and whether the VAD was removed unexpectedly.

Results

There were 231 midlines and 97 PICCs inserted into 64 patients (39 male and 25 female; age range 18–47 years old). Presented as per 1000 VAD days, patients with PICCs and midlines had similar rates of adverse events (14 and 11 adverse events per 1000 VAD days, respectively). Unexpected removal was higher for patients with midlines (6.90 per 1000 VAD days) than for PICCs (2.89 per 1000 VAD days). Incident rate ratios (IRRs) showed that patients with midlines and PICCs had similar rates of adverse events (IRR 1.18, P = 0.617, CI 0.62–2.22) although the removal rate of patients with midlines was twice that of patients with PICCs (IRR 2.24, P = 0.079, CI 0.91–5.56). As an absolute risk there were only 4.09 more cases of removal for patients with midlines per 1000 VAD days than those with PICCs.

Conclusions

Midlines may be an alternative to PICCs for adult CF patients although further research is required with a larger sample size to enable definitive conclusions.
Keyword Catheters vascular
Catheterisation-adverse effects
Cystic fibrosis
Midlines
Observational
Peripherally inserted central catheters
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Wed, 11 Nov 2015, 11:24:57 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work