J Neurointensive Care > Volume 6(2); 2023 > Article |
|
Ethics statement
All study procedures involving human subjects were performed in accordance with the ethical standards of our Institutional Review Board (No. SGPAIK 2023-08-013) and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
MC: Midline catheter, CCVC: Conventional central venous catheter, PICC: Peripherally inserted central venous catheter, IQR: interquartile range; n(%): Number of patients (%), SAH: Subarachnoid hemorrhage, ICH: Intracerebral hemorrhage, IVH: Intraventricular hemorrhage, APACHE: Acute Physiology and Chronic Health Evaluation.
MC (n=57) | CCVC (n=36) | PICC (n=32) | p-value | |
---|---|---|---|---|
Indication, n (%) | ||||
Difficult IV access* | 24 (42.1) | 3 (8.3) | 0 (0) | < 0.001 |
IV fluid Maintenance | 11 (19.3) | 5 (13.9) | 18 (56.3) | 0.582 |
Infusion of drug | 22 (38.6) | 14 (38.9) | 14 (43.8) | 1.000 |
For operation | 0 (0) | 13 (36.1) | 0 (0) | < 0.001 |
GCS score median (IQR) | 12.5 (7.50–13.0) | 9.5 (6.0–14.0) | 8.5 (6.0–14.0) | 0.626 |
Use of ventilator, n (%) | 8 (14.0) | 18 (50.0) | 17 (53.1) | < 0.001 |
Use of vasopressor, n (%) | 1 (1.8) | 7 (19.4) | 4 (12.5) | 0.005 |
Operators n (%) | ||||
Residents | 57 (100.0) | 30 (83.3) | 0 (0) | |
Specialist | 0 (0) | 6† (16.7) | 32 (100.0) | |
Location, n (%) | ||||
ICU | 57 (100.0) | 21 (58.3) | 8 (25.0) | |
Others | 0 (0) | 15 (41.7) | 24 (75.0) | < 0.001 |
Paretic arm placement, n (%) | 0 (0) | 0 (0) | 0 (0) | |
Accessed vein, n (%) | ||||
Basilic | 40 (70.0) | 0 (0) | 22 (68.8) | |
Brachial | 14 (24.6) | 0 (0) | 9 (28.1) | |
Cephalic | 3 (5.3) | 0 (0) | 1 (3.1) | |
Subclavian | 0 (0) | 18 (50.0) | 0 (0) | |
Jugular | 0 (0) | 2 (5.6) | 0 (0) | |
Femoral | 0 (0) | 16 (44.4) | 0 (0) | |
French of catheter, n (%) | ||||
4 | 57 (100.0) | 0 (0) | 5 (15.6) | |
5 | 0 (0) | 0 (0) | 25 (78.1) | |
6 | 0 (0) | 0 (0) | 2 (6.3) | |
7 | 0 (0) | 36 (100.0) | 0 (0) | |
Lumen, N (%) | ||||
1 | 57 (100.0) | 0 (0) | 5 (15.6) | |
2 | 0 (0) | 4 (11.1) | 25 (78.1) | |
3 | 0 (0) | 32 (88.9) | 2 (6.3) | |
Laboratory parameters, median (IQR) | ||||
Platelet (×103/µL) | 207 (173.3–249.3) | 231 (155.5–300.5) | 179.5 (152.0–226.0) | 0.322 |
PT-INR | 1.08 (1.0–1.19) | 1.09 (1.0–1.2) | 1.09 (1.0–1.2) | 0.335 |
aPTT (sec) | 36.9 (33.6–45.2) | 37.35 (31.9–46.8) | 36 (33.4–40.2) | 0.880 |
MC (n=57) | CCVC (n=30) | PICC (n=32) | p-value | |
---|---|---|---|---|
Number of insertion attempts, n (%) | ||||
1 | 55 (96.5) | 24 (80.0) | 28 (87.5) | |
2 | 2 (3.5) | 6 (20.0) | 4 (12.5) | |
More | 0 (0) | 0 (0) | 0 (0) | |
First attempt success rate | 0.965 | 0.8 | 0.875 | 0.003 |
Procedure time, median (IQR) | 10 (5.0–20.0) | 13 (10.0–20.8) | 17 (12.0–20.0) | 0.332 |
Insertional injury, n (%) | 0 (0) | 4 (13.3) | 0 (0) | 0.012 |
Pneumothorax | 0 (0) | 2 (6.7) | 0 (0) | 0.147 |
Incision site bleeding | 0 (0) | 2 (6.7) | 0 (0) | 0.147 |
Other | 0 (0) | 0 | 0 (0) | |
Ultrasound guided procedure | 57 | 11 | 32 | < 0.001 |
Dwell time (Days), median (IQR) | 11 (7.0–14.0) | 7.5 (2.0–15.0) | 21 (15.0–29.0) | 0.114 |
Cause of removal, n (%) | ||||
Completion of therapy | 49 (86.0) | 16 (53.3) | 25 (78.1) | 0.002 |
Death before completion | 3 (5.3) | 1 (3.3) | 3 (9.4) | |
Death after completion | 1 (1.8) | 1 (3.3) | 2 (6.3) | |
Dislodgement | 2 (3.5) | 1 (3.3) | 2 (6.3) | |
CRBSI* | 2 (3.5) | 2 (6.7) | 2 (6.3) | |
Major complication, n (%) | 2 (3.5) | 4 (13.3) | 2 (6.3) | 0.177 |
Serious insertional injury | 0 (0) | 2 (6.7) | 0 (0) | 0.147 |
CRBSI | 2 (3.5) | 2 (6.7) | 2 (6.3) | 0.606 |
Symptomatic catheter related DVT | 0 (0) | 0 (0) | 0 (0) | |
Bleeding required beyond compression | 0 (0) | 0 (0) | 0 (0) | |
Minor complication, n (%) | 3 (5) | 6 (20.0) | 3 (9.4) | |
Insertion site bleeding | 0 (0) | 2 (6.7) | 0 (0) | |
Catheter dislodgement / occlusion | 2 (3.5) | 2 (6.7) | 2 (6.3) | |
Leakage | 0 (0) | 0 (0) | 0 (0) | |
Phlebitis | 1 (1.8) | 2 (6.7) | 1 (3.1) | |
Total complication | 5 (8.8) | 10 (33.3) | 5 (15.7) | 0.007 |