P63 | Is the peripheral vascular access midline-type the ideal device for the patient admitted to Internal Medicine? A 12-month retrospective analysis

E. Dino, A. Martella, M. Cavaliere, P. Marchetti, F. Novo, J. Scaranaro, G. Giglia, B. Marenda, A. Moroldo, A. Mazza | UOC Medicina Interna, Adria (RO), Italy

Abstract

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.