Midline catheters in patients with advanced chronic kidney disease

This study describes current practice and acute complications associated with midlines in CKD patients.Designs, Setting, and ParticipantsTrained abstractors at 66 hospitals from the Michigan Hospital Medicine Safety (HMS) Consortium collected data on a sample of patients who received a midline during hospitalization. Patients were classified as having advanced CKD if their estimated glomerular filtration rate was<45 mL/min/1.73 m2.Main Outcome and MeasuresMidline recipients with advanced CKD were compared to those without advanced CKD by patient, provider, and device characteristics, and by the occurrence of acute complications including major (e.g., upper extremity deep vein thrombosis [UE-DVT] and catheter-related bloodstream infection [CRBSI]) or minor (e.g., catheter occlusion, catheter dislodgement, infiltration, superficial thrombophlebitis, and leaking at insertion site) events. Multivariable mixed effects logistic regression was used to evaluate the association between catheter-related complications and stage of CKD.ResultsOf 21,415 midline recipients, 5272 (24.6%) had advanced CKD, while 16,143 (75.4%) did not. Most midlines were single lumen (90.5%) and remained in place for a median of 6 days. A major or minor midline complication occurred in 804 (15.3%) patients with and 2239 (14.4%) patients without advanced CKD (adjusted odds ratios  = 1.04; 95% confidence interval: 0.94–1.14). Among patients with advanced CKD, CRBSI occurred in 13 patients (0.2%) and U...
Source: Journal of Hospital Medicine - Category: Hospital Management Authors: Tags: ORIGINAL RESEARCH Source Type: research