None listed
Conditions
Brief summary
Midline Catheters (MCs) and Peripherally Inserted Central Catheters (PICCs) are devices which are inserted peripherally into a vein in the upper arm under ultrasound guidance. These are used to deliver medical treatment, including medicines, fluids, and blood transfusions. The main difference between these two devices is the length of the catheter, and where the tip of the device ends (MC, near the shoulder; PICC, centrally). This randomised controlled trial involves being randomly allocated to one of two arms: • Insertion of a Peripherally Inserted Central Catheter (50-55cms) • Insertion of a Midline Catheter (8-20cms) The aim of the trial is to compare MC with PICC for patients requiring prolonged intravenous therapy (up to or equal to 29 days). The researchers hypothesise there will be no significant difference for all-cause device failure between patients who receive a MC versus a PICC.
Interventions
Participants in this study will be consented, randomised and allocated to one of the two following randomly assigned options:
Arm 1 (Control): Peripherally Inserted Central Catheter (PICC)
Arm 2 (Intervention): Midline Catheter (MC)
PICC and MC insertions will take place in either a dedicated procedure room or at the bedside by a nurse with established skills, using ultrasound, and a sterile technique. Both devices are inserted in the upper arm of the patient but they differ in the length of the
Participants in this study will be consented, randomised and allocated to one of the two following randomly assigned options: Arm 1 (Control): Peripherally Inserted Central Catheter (PICC) Arm 2 (Intervention): Midline Catheter (MC) PICC and MC insertions will take place in either a dedicated procedure room or at the bedside by a nurse with established skills, using ultrasound, and a sterile technique. Both devices are inserted in the upper arm of the patient but they differ in the length of the device and ultimately, the final tip location. PICCs terminate in the central venous system, ideally at the cavoatrial junction. MCs terminate in the peripheral venous circulation, distal to the axilla. Strategies that will be implemented to monitor fidelity to the intervention will include comprehensive training and ongoing support for the inserting clinicians. PICC and MC insertion duration can vary depending on a patient's individual venous access. PICC insertion bookings typically allow for 1 hour. MC insertion is anticipated to be approximately 30 minutes in duration. The allocated device will remaining insitu until it is removed by the patients’ treating clinicians as per usual clinical practice. For example, if the device is no longer needed, if suspected of infection, is painful, the site is swollen, or the device dysfunctions (e.g. leaks, dislodges or occludes).
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Informed consent to participate • The treating team have referred the patient to receive a PICC with peripherally-compatible intravenous therapy • Patient expected to receive IV therapy for up to or equal to 29 days • The treating team has approved the use of either a MC or PICC.
Exclusion criteria
• Non-English speakers without interpreter • Patient receiving end-of-life care • Patient with a history of venous thromboembolism or renal disease • Cognitive barrier to consent (without a SDM) • Previous enrolment in this study • Patient receiving chemotherapy treatment • Patient lives outside Metro North Hospital and Health Service. • History of intravenous drug use in the last one year
Outcome results
None listed