[The assessment of the effectiveness of long vs standard-length catheters in reducing complications: a randomized controlled trial]

Assist Inferm Ric. 2015 Jul-Sep;34(3):116-24. doi: 10.1702/2038.22136.
[Article in Italian]

Abstract

Introduction: From 30 to 80% of hospitalized patients is inserted a peripheral venous catheter (PVC). The PVC may be associated to several infective and non infective complications.

Aims: To assess whether a long-length vs standard-length PCV reduces the incidence of CRCs; to assess the patients' preferences and costs.

Methods: Randomized clinical trial on 211 patients (339 cannulas) admitted to an emergency medical and surgical wards. Patients were included if >18 years and prescribed a PVC. After the randomization the PVC were inspected daily, until removal.

Results: 186 complications occurred with the standard CVPs vs 16 with the midline, per 1000 catheter days; 47 phlebitis were observed in patients with standard PVCs vs none in those with midline; also infiltrations (66 vs 2 per 1000 catheter days), asymptomatic thromboses (34 vs 7 per 1000 catheter days), occlusions and accidental removals were greatly reduced. The higher cost of midline is counterbalanced by the complications prevented. In addition midline patients referred less limitations (96% vs 50.7%) and an higher satisfaction (91.9% vs 53.7%).

Conclusions: The midline catheters radically reduce PVC associated complications, are preferred by patients and the higher costs should be weighted against the complications avoided.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / economics
  • Catheterization, Peripheral / methods
  • Catheterization, Peripheral / nursing*
  • Catheters* / adverse effects
  • Catheters* / economics
  • Cost-Benefit Analysis
  • Device Removal / nursing*
  • Emergency Service, Hospital
  • Female
  • Humans
  • Inpatients*
  • Internal Medicine
  • Italy
  • Male
  • Phlebitis / nursing*
  • Phlebitis / prevention & control
  • Risk Assessment
  • Risk Factors
  • Surgery Department, Hospital
  • Venous Thrombosis / nursing*
  • Venous Thrombosis / prevention & control