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Safety and Efficacy of Midline and PICC

Not Applicable
Completed
Conditions
Central Venous Catheter
Vascular Access Devices
Interventions
Device: Bard PowerPICC
Device: Bard PowerMidline catheter
Registration Number
NCT03502980
Lead Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Brief Summary

The purpose of this study is to assess the non-inferiority for safety and efficacy of using Midline in comparison with PICC for intravenous therapy that do not require a central catheter.

Detailed Description

Vascular access devices (VADs), including peripherally inserted central venous catheters (PICCs) remain a cornerstone for the delivery of necessary intravenous therapy. PICCs are being selected for venous access more frequently today than ever before.

The advantage of PICC is that it can be used for all intravenous therapy. However, PICC requires the use of fluoroscopy or other type of guidance which add to the cost and time required to insert the catheter. Midline, on the other hand, can be inserted under ultrasound guidance, takes less time to be inserted and cost less than PICC insertion.

Despite lower cost and better accessibility of midline in comparison with PICC for non-vesicant intravenous therapy, there is very little evidence in the literature to suggest that one type of venous access is better than the other.

The primary objective of this study is to assess the non-inferiority for safety and efficacy of using Midline in comparison with PICC for intravenous therapy that do not require a central catheter.

Results of this trial will allow improving a quality of evidence for using midline instead of PICC for specified indications. If Midline are non-inferior for some indications, they would represent a more accessible and less expensive alternative than PICC insertion.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
293
Inclusion Criteria
  • Required intra venous therapy
  • Expected duration of the venous access: > 6 days and < 30days
Exclusion Criteria
  • Patient has a contraindication to insertion of either a Midline or a PICC relative to the therapy
  • Patient from other hospitals who come to the CHUM only for the installation of a central line
  • Decreased cognitive ability to care for device at home
  • Preexisting bacteremia (ie, existing positive blood cultures that had not been repeated with negative results)
  • Preexisting venous thrombosis or known hypercoagulable states (such as protein C or S deficiency, antithrombin deficiency, lupus anticoagulant)
  • Venous access with multiple lumens required
  • Patients not able to give informed consent
  • Prior participation to this study
  • Patient is enrolled in another investigational study
  • Patients hospitalized in the intensive care unit
  • Patients who are difficult to puncture and require multiple blood samples

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Peripherally inserted central venous cathetersBard PowerPICCBard PowerPICC
MidlineBard PowerMidline catheterBard PowerMidline catheter
Primary Outcome Measures
NameTimeMethod
% of patients without VAD-related adverse event requiring medical interventionUntil 1 week after VAD retrieval

Infections, Thrombophlebitis, Infiltration, Bleeding, Pain, Death

% of patients whose intended or additional I.V treatments could be completed with the VAD without VAD complications, dysfunctions or limitations (ex: need for central access or for additional peripheral or central lumens/catheters)Until 1 week after VAD retrieval
Secondary Outcome Measures
NameTimeMethod
% of patients who required another VAD to complete the intended or additional iv treatments, either because of VAD complications, dysfunctions or limitationsUntil 1 week after VAD retrieval
% of patients for whom the end of treatment was the reason for VAD retrievalUntil 1 week after VAD retrieval
% of patients who experience VAD-related adverse events requiring medical interventionUntil 1 week after VAD retrieval

Infections, Thrombophlebitis, Infiltration, Bleeding, Pain, Death

Time to first VAD-related adverse eventsUntil 1 week after VAD retrieval
% of patient without failed blood sampling attempts through the VADUntil 1 week after VAD retrieval
Number of VAD-related adverse events requiring medical intervention per 1000 catheter/daysUntil 1 week after VAD retrieval
Duration VAD intervention (Midline or PICC)Index procedure
Number of additional interventions to insert the VADIndex procedure

Trial Locations

Locations (1)

Centre hospitalier de l'université de Montréal

🇨🇦

Montreal, Quebec, Canada

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