![]() This study demonstrates that midline catheters are a safe alternative to CVCs, for the safe and efficacious administration of vasopressors for prolonged periods of time.ĬLABSI Central lines Midlines Peripheral IV access Safety Vasoactive medications Vasopressors.Ĭopyright © 2020 Elsevier Inc. Many medical centers are attempting to limit the use of central venous catheters (CVCs) to avoid central line-associated bloodstream infections (CLABSIs). ![]() However, about one-fourth of PIVCs are left in situ with no prescriber orders for IV medications or solutions, just in case they might be needed. There were no complications related to ineffective drug delivery or limb endangerment. Abstract In Brief Peripheral intravenous catheters (PIVCs) are among the most common invasive devices used in hospitalized patients, with over 300 million sold in the United States each year. Late Complication rate was 0.8% (n = 2) due to midline-associated DVTs. ![]() Early Complication rate was 3.6% due to Bloodstream infection (n = 6), drug extravasation (n = 1), thrombophlebitis (n = 1) and arterial puncture (n = 1). Additional analysis of those patients with a diagnosis of cancer with a CVC was conducted ( Table 7 ) with respect to the number of catheters that had to be removed due to the. Vasopressors used with their average dose (AD) were norepinephrine (n = 165, 16.8 CE ± 10.7 μg/min), epinephrine (n = 56, 9.1 CE ± 6.0 μg/min), vasopressin (n = 123, 0.05 CE ± 0.02 units/min), phenylephrine (n = 158, 91.4 CE ± 64.7 μg/min) and Angiotensin II (50 CE ± 27.6 ng/kg/min). Seventy-five removals in total were recorded: 31 for open-ended PICCs, 18 for valved PICCs, 21 for open-ended midline catheters, and 5 for valved midline catheters. The average midline dwell time was 14.7 ± 12.8 days and the average duration of continuous vasopressor infusion was 7.8 ± 9.3 days. This is a retrospective study between 20 looking at the outcomes of midline catheters.Ĥ5 bed Tertiary level ICU in a 600-bed teaching hospital.Ī total of 248 patients received vasopressors via midline catheters. The primary objective of this study is to determine the safety and efficacy of long term administration of vasopressors through a midline catheter. The use of vasopressors through midline catheters has not yet been evaluated. Unlike peripheral IVs, midline catheters provide a wider lumen with the catheter tip ending in a large peripheral vein. Since each subspecialty brings unique expertise and experience to the field, this handbook will be a valuable resource for all physicians currently working in peripheral vascular interventions.Vasopressors are commonly administered through Central Venous Catheters (CVCs) as it is considered unsafe to administer them via peripheral IVs, mainly due to the concern of local tissue injury. Yerem Yeghiazarians (Division of Interventional Cardiology), from the University of California San Francisco School of Medicine, the Handbook of Endovascular Peripheral Interventions is a collaborative effort between cardiologists, vascular surgeons, and radiologists. ![]() Owens (Division of Vascular Surgery) and Dr. These invaluable pearls are provided by contributing chapter authors who are experts in the field.Įdited by Dr. Importantly, Tips of the Trade and How I Do It sections within each chapter make the handbook practical for daily use. Covering all aspects of percutaneous peripheral vascular interventions, each chapter of this highly illustrated book provides a brief background, etiology, clinical presentation, imaging, and percutaneous treatment of different vascular conditions. The Handbook of Endovascular Peripheral Interventions has been written to serve as a comprehensive guide for both the beginner and advanced interventionalist. ![]()
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