TY - JOUR
T1 - Comparing the use of midline catheters versus peripherally inserted central catheters for patients requiring peripherally compatible therapies : a pilot randomised controlled trial (the compact trial)
AU - Marsh, Nicole
AU - Larsen, Emily N.
AU - O'Brien, Catherine
AU - Groom, Peter
AU - Kleidon, Tricia M.
AU - Alexandrou, Evan
AU - Young, Emily
AU - McCarthy, Kate
AU - Rickard, Claire M.
PY - 2023/11
Y1 - 2023/11
N2 - Background: Midline catheter (MC) use has increased in acute-care settings, particularly for patients with difficult venous access or requiring peripherally compatible intravenous therapy for up-to 14 days. Our aim was to assess feasibility and generate clinical data comparing MCs with Peripherally Inserted Central Catheters (PICCs). Methods: A two-arm parallel group pilot randomised controlled trial (RCT), comparing MCs with PICCs, was conducted in a large tertiary hospital in Queensland between September 2020 and January 2021. The primary outcome was study feasibility, measured against rates of eligibility (>75%), consent (>90%), attrition (<5%); protocol adherence (>90%) and missing data (<5%). The primary clinical outcome was all-cause device failure. Results: In total, 25 patients were recruited. The median patient age was 59–62 years; most patients were overweight/obese, with ≥2 co-morbidities. Primary outcomes: The eligibility and protocol adherence criteria were not met; of 159 screened patients, only 25 (16%) were eligible, and three patients did not receive their allocated intervention post-randomisation (88% adherence). All-cause failure occurred in two patients allocated to MC (20%) and one PICC (8.3%). Conclusions: Our study found that a fully powered RCT testing MCs compared with PICCs is not currently feasible in our setting. We recommend a robust process evaluation before the introduction of MCs into clinical practice.
AB - Background: Midline catheter (MC) use has increased in acute-care settings, particularly for patients with difficult venous access or requiring peripherally compatible intravenous therapy for up-to 14 days. Our aim was to assess feasibility and generate clinical data comparing MCs with Peripherally Inserted Central Catheters (PICCs). Methods: A two-arm parallel group pilot randomised controlled trial (RCT), comparing MCs with PICCs, was conducted in a large tertiary hospital in Queensland between September 2020 and January 2021. The primary outcome was study feasibility, measured against rates of eligibility (>75%), consent (>90%), attrition (<5%); protocol adherence (>90%) and missing data (<5%). The primary clinical outcome was all-cause device failure. Results: In total, 25 patients were recruited. The median patient age was 59–62 years; most patients were overweight/obese, with ≥2 co-morbidities. Primary outcomes: The eligibility and protocol adherence criteria were not met; of 159 screened patients, only 25 (16%) were eligible, and three patients did not receive their allocated intervention post-randomisation (88% adherence). All-cause failure occurred in two patients allocated to MC (20%) and one PICC (8.3%). Conclusions: Our study found that a fully powered RCT testing MCs compared with PICCs is not currently feasible in our setting. We recommend a robust process evaluation before the introduction of MCs into clinical practice.
UR - https://hdl.handle.net/1959.7/uws:73451
U2 - 10.1016/j.idh.2023.03.007
DO - 10.1016/j.idh.2023.03.007
M3 - Article
SN - 2468-0451
VL - 28
SP - 259
EP - 264
JO - Infection , Disease and Health
JF - Infection , Disease and Health
IS - 4
ER -