Peripherally inserted central catheter, midline, and “short” midline in palliative care: Patient-reported outcome measures to assess impact on quality of care

Abstract

Objectives: A prospective, observational study was conducted in our palliative care unit to assess the impact of peripherally inserted central catheters (PICCs), midline, and “short” midline catheters on the quality of care in cancer and non-cancer patients. The secondary objective was to assess pain and distress during vascular access device insertion. Methods: Patients were recruited if they underwent insertion of a PICC, midline, or “short” midline catheter as part of their standard care. The Palliative care Outcome Scale was used to assess changes in quality of care after vascular access device positioning. A numerical rating scale was used to measure pain intensity during catheter insertion. Results: Of the 90 patients enrolled, 52.2% were male with a mean age of 73.0 ± 13 years. Among these patients, 64.4% patients underwent “short” midline insertion, 26.7% PICC, and 8.9% midline catheter. The patients’ mean baseline Palliative care Outcome Scale score was 15.7 ± 5.6. Three days after vascular access device positioning, the patients’ mean Palliative care Outcome Scale score was 11.5 ± 5.5 (p < 0.0001). Mean pain score during vascular access device insertion was 1.26 ± 1.63, and mean procedural distress score was 1.78 ± 1.93. Conclusion: These findings suggest that medium-term intravenous catheters can have a favorable impact on quality of care and the procedures for these vascular access device insertions are well tolerated. Further research on the performance of different vascular access devices and their appropriateness in palliative care should be encouraged.

The efficacy of midline catheters—a prospective, randomized, active-controlled study

“…Consequently, the catheter tip is placed in close proximity to the central veins. New-generation midline catheters can easily be placed bedside by a single operator under ultrasound guidance and they provide the same patient comfort as PICCs (Magnani et al, 2019;Bundgaard Madsen et al, 2020;Spiegel et al, 2020). Furthermore, we have recently shown that these midline catheters have a survival time of approximately 14 days before premature removal, as calculated from the time at risk (Bundgaard Madsen et al, 2020).…”

Usefulness of Midline Catheters versus Peripheral Venous Catheters in an Inpatient Unit: A Pilot Randomized Clinical Trial

“…People will suffer fewer venipunctures and, therefore, less pain, improving their quality of life and perception of intravenous therapy [ 40 ]. Indicators show that intravenous catheters in the medium term can favor the quality of care and that the procedures for inserting these vascular access devices are well tolerated [ 41 ].…”

Impact of terminal tip location of midline catheters on catheter‐related complications and indwelling duration in elderly patients

“…Other investigators have reported that the incidence of infiltration can be reduced by appropriately extending the length of the MC (Deutsch et al, 2014). A study by Magnani et al similarly concluded that complications were reduced when the catheter tip was located in the distal segment of the axillary vein (Magnani et al, 2019). Our observations are consistent with these conclusions.…”