The longer the catheter, the lower the risk of complications: Results of the HERITAGE study comparing long peripheral and midline catheters.

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES American journal of infection control Pub Date : 2024-06-27 DOI:10.1016/j.ajic.2024.06.019

Adam Fabiani, Nicola Aversana, Marilena Santoro, Dario Calandrino, Paolo Liotta, Gianfranco Sanson

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Abstract

Background: Although widely used in clinical practice, long peripheral (LPCs) and midline catheters (MCs) are often misclassified because of their similar characteristics. Comparative studies on these devices are lacking. This study aimed to explore complications risks in polyurethane LPCs and MCs.

Methods: Prospective cohort study. Catheter-failure within 30days was the primary outcome, catheter-related bloodstream infection (CR-BSI), thrombosis, and fibroblastic sleeve were secondary outcomes. The average number of drugs infused per day was computed to measure the overall intensity of catheters' use.

Results: The catheter-failure incidence was 5.7 and 3.4/1,000 catheter-days for LPCs and MCs, respectively. MCs were associated with an adjusted lower risk of catheter-failure (hazard ratio 0.311, 95% confidence interval 0.106-0.917, P = .034). The daily number of drugs infused was higher for MCs (P < .001) and was associated with a greater risk catheter-failure risk (P = .021). Sensitivity analysis showed a decreased catheter-failure risk for MCs starting from day-10 from positioning. The incidence of CR-BSI (0.9 vs 0.0/1,000 catheter-days), thrombosis (8.7 vs 3.5/1,000 catheter-days), and fibroblastic sleeve (14.0 vs 8.1/1,000 catheters-days) was higher for LPC catheters.

Conclusions: Despite more intensive drug administration, MCs were associated with a longer uncomplicated indwelling time.

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导管越长，并发症风险越低：比较长外周导管和中线导管的 HERITAGE 研究结果。

背景：尽管长外周导管（LPC）和中线导管（MC）被广泛应用于临床实践，但由于它们具有相似的特征，因此经常被误分。目前还缺乏比较这些设备相关并发症的研究。本研究旨在探讨与聚氨酯长外周导管和中线导管相关的并发症风险：方法：前瞻性队列研究。纳入研究期间插入的所有 LPC 和 MC。30天内导管故障是主要结果，导管相关血流感染、血栓形成和纤维套管是次要结果。作为导管留置期间使用强度的衡量标准，计算了每天平均输注的药物数量：结果：LPC 和 MC 的导管故障发生率分别为 5.7 和 3.4/1000 个导管日。经调整后，MC 的导管故障风险更低（HR 0.311；95% CI 0.106-0.917；P=0.034）。MC每天平均输注的药物数量更高（导管定位后的第p天）。LPCs导管的导管相关血流感染（0.9 vs 0.0/1000导管日）、血栓形成（8.7 vs 3.5/1000导管日）和纤维套管（14.0 vs 8.1/1000导管日）发生率更高：结论：尽管给药强度更大，但 MC 型导管的无并发症留置时间更长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)