Retrospective analysis shows midline-type vascular access effectiveness in hospitalized patients, suggesting improved management strategies.
Premises and Purpose of the study: In patients (pts) hospitalized in Internal Medicine wards, the use of intravenous access is the most common invasive procedure. International guidelines (LGs) recommended a “pro-active” approach which involves early medical-nurse evaluation and management of the patient’s venous heritage. The efficacy and safety of a midline-type (MID) vascular access was evaluated retrospectively.Materials and Methods: In 283 pts (35,7% men), mean age (81.3±11.0 yrs), consecutively admitted from December 2022 to November 2023, a MID was placed according to the 2022 GaVe-CELT LGs. Biochemical tests and color-doppler ultrasonography were performed before and after MID placement. Statistical analysis was performed using the SPSS package 29.0. Results: In 7.7% (22 cases) the MID was re-placed for self-removal (22,7%), deep-vein thrombosis (31.8%), non-thrombotic occlusion (27.2%) and for bacterial infection (18.2%), respectively. In the re-placed MIDs, there was a pre-existing septicemia (61.5%), but in 4 cases only the MID was infected; the bacterial species mostly found was staphylococcus epidermidis (45%). In the 56.5%, pts were discharged to low-intensity healthcare facilities, benefiting from the MID placed.Conclusions: The device placement was effective and safe, as there was a re-placement of them in 6.0% of cases (excluding self-removals), quite in line as required by LG (<=5%). Adequate management of post-implantation of MID is mandatory to prevent catheter-related complications, to reduce patient’s clinical risk and health-care costs-saving.
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