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Safety and Outcomes of Midline and Peripherally Inserted Central Catheters in a Pediatric Intensive Care Unit

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Abstract

Objectives

We describe our experience with use of midline catheters in PICU and compare the performance of midline catheters to peripherally inserted central catheters (PICC).

Methods

A review of hospital records was done to including all pediatric patients admitted in the pediatric intensive care unit of a tertiary care centre who underwent placement of midline catheters or PICC, over a period of 18 months (July, 2019 to January, 2021). Patient details, indication, type of catheter and number of attempts at insertion, type and number of infusions administered, dwell time and complications were retrieved from the records. Comparison was made between the midline and PICC groups.

Results

The median (IQR) age of children was 7 (3–12) years (75.5% males). 161 midline catheters and 104 PICC were inserted with first attempt success rates of 87.6% and 78.8%, respectively. Median cubital vein was used for majority of the insertions (52.8%). Common complications with midline catheters were pain (n=9, 5.6%), blockage (n=8, 5%) and thrombophlebitis (n=6, 3.7%). Median (interquartile range) dwell time in midline group was 7 (5–10) days. The duration of backflow and dwell time were higher in the PICC group compared to midline group (5.5 vs 3 days; P<0.001 and 9 vs 7 days; P<0.001, respectively).

Conclusion

Retrospective data showed that midline catheters had good utility in PICU, especially in moderately sick children (PRISM score up to 12), and provide a secure intravenous access, which can last for a week.

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References

  1. Glazner J, Steinfort K, Hu YJ, et al. Short midline catheters: High success rates for antibiotic therapy in children with cystic fibrosis. J Vasc Access. 2021;23:11297298211035310.

    Google Scholar 

  2. Adams DZ, Little A, Vinsant C, Khandelwal S. The midline catheter: A clinical review. J Emerg Med. 2016;51:252–8.

    Article  PubMed  Google Scholar 

  3. Lescinskas EH, Trautner BW, Saint S, et al. Use of and patient-reported complications related to midline catheters and peripherally inserted central catheters. Infect Control Hosp Epidemiol. 2020;41:608–10.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ben Abdelaziz R, Hafsi H, Hajji H, et al. Peripheral venous catheter complications in children: predisposing factors in a multicenter prospective cohort study. BMC Pediatr. 2017;17:208.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Nielsen EB, Antonsen L, Mensel C, et al. The efficacy of mid-line catheters-a prospective, randomized, active-controlled study. Int J Infect Dis. 2021;102:220–5.

    Article  PubMed  Google Scholar 

  6. Naik VM, Mantha SSP, Rayani BK. Vascular access in children. Indian J Anaesth. 2019;63:737–45.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kuensting LL, DeBoer S, Holleran R, et al. Difficult venous access in children: taking control. J Emerg Nurs. 2009;35:419–24.

    Article  PubMed  Google Scholar 

  8. Govindan S, Snyder A, Flanders SA, et al. Peripherally Inserted Central Catheters in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals. Crit Care Med. 2018;46:e1136–44.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Vallecoccia MS, De Pascale G, Taraschi C, et al. Closed vs open systems: when should short peripheral intravenous catheters be the first choice? J Hosp Infect. 2015;89:72–3.

    Article  CAS  PubMed  Google Scholar 

  10. Prasanna N, Yamane D, Haridasa N, et al. Safety and efficacy of vasopressor administration through midline catheters. J Crit Care. 2021;61:1–4.

    Article  CAS  PubMed  Google Scholar 

  11. Spiegel RJ, Eraso D, Leibner E, et al. The utility of midline intravenous catheters in critically Ill emergency department patients. Ann Emerg Med. 2020;75:538–45.

    Article  PubMed  Google Scholar 

  12. Centers for Disease Control and Prevention (CDC). Background information–2011 BSI guidelines–HICPAC 2016. Accessed February 21, 2022. Available from: http://www.cdc.gov/hicpac/BSI/04-bsi-background-info-2011.html

  13. Swaminathan L, Flanders S, Horowitz J, et al. Safety and outcomes of midline catheters vs peripherally inserted central catheters for patients with short-term indications: A multicenter study. JAMA Intern Med. 2022;182:50–8.

    Article  PubMed  Google Scholar 

  14. Tao F, Wang X, Liu J, et al. Perioperative application of midline catheter and PICC in patients with gastrointestinal tumors. J BUON. 2019;24:2546–52.

    PubMed  Google Scholar 

  15. Tripathi S, Kumar S, Kaushik S. The practice and complications of midline catheters: A systematic review. Crit Care Med. 2021;49:e140–50.

    Article  PubMed  Google Scholar 

  16. Johansson E, Hammarskjöld F, Lundberg D, Arnlind MH. Advantages and disadvantages ofperipherally inserted central venous catheters (PICC) compared to other central venous lines: A systematic review of the literature. Acta Oncol. 2013;52:886–92.

    Article  PubMed  Google Scholar 

  17. ARISE Investigators, ANZICS Clinical Trials Group, Peake SL, Delaney A, et al: Goal directed resuscitation for patients with early septic shock. N Engl J Med. 2014;371:1496–506.

    Article  Google Scholar 

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Acknowledgements

Manish Singh (Senior Biostatistician, M.I.E.R) for his advice on statistical analysis.

Funding

Funding: None

Author information

Authors and Affiliations

  1. Pediatric Intensive Care Unit, Medanta, the Medicity, Sector 38, Gurugram, Haryana, 122 001, India

    Veena Raghunathan, Maninder Dhaliwal & Dhirendra Pratap Singh

  2. Research and Clinical studies, Medanta Institute of Education and Research, Sector 38, Gurugram, Haryana, India

    Gargi Singh

  3. Division of Pediatrics, Medanta, the Medicity, Sector 38, Gurugram, Haryana, India

    Sunit Singhi

Authors
  1. Veena Raghunathan
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  2. Maninder Dhaliwal
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  3. Dhirendra Pratap Singh
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  4. Gargi Singh
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  5. Sunit Singhi
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Contributions

Contributors: VR, MD conceptualized and designed the study, DS collected data, GS carried out statistical analysis of data, VR, MD, DS carried out the study and drafted the initial manuscript, SS critically reviewed the manuscript for important intellectual content, VR, SS- reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work

Corresponding author

Correspondence to Veena Raghunathan.

Ethics declarations

Ethics clearance: Medanta Institutional Ethics Committee; No. 1335/2021, dated Aug 10, 2021.

Competing interests: None stated.

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Raghunathan, V., Dhaliwal, M., Singh, D.P. et al. Safety and Outcomes of Midline and Peripherally Inserted Central Catheters in a Pediatric Intensive Care Unit. Indian Pediatr 60, 731–735 (2023). https://doi.org/10.1007/s13312-023-2986-1

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  • DOI: https://doi.org/10.1007/s13312-023-2986-1

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