[The assessment of the effectiveness of long vs standard-length catheters in reducing complications: a randomized controlled trial].
BACKGROUND
From 30 to 80% of hospitalized patients is inserted a peripheral venous catheter (PVC). The PVC may be associated to several infective and non infective complications.


OBJECTIVE
To assess whether a long-length vs standard-length PCV reduces the incidence of CRCs; to assess the patients' preferences and costs.


METHODS
Randomized clinical trial on 211 patients (339 cannulas) admitted to an emergency medical and surgical wards. Patients were included if >18 years and prescribed a PVC. After the randomization the PVC were inspected daily, until removal.


RESULTS
186 complications occurred with the standard CVPs vs 16 with the midline, per 1000 catheter days; 47 phlebitis were observed in patients with standard PVCs vs none in those with midline; also infiltrations (66 vs 2 per 1000 catheter days), asymptomatic thromboses (34 vs 7 per 1000 catheter days), occlusions and accidental removals were greatly reduced. The higher cost of midline is counterbalanced by the complications prevented. In addition midline patients referred less limitations (96% vs 50.7%) and an higher satisfaction (91.9% vs 53.7%).


CONCLUSIONS
The midline catheters radically reduce PVC associated complications, are preferred by patients and the higher costs should be weighted against the complications avoided.
Qualità e Accreditamento ASLTO2.
Tiziana
T
De Prospo
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Antonia
A
Attini
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Renato
R
De Giorgi
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Stefania
S
Farinelli
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Daniela
D
Joli
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Francesca
F
Maddalena
MeCAU, Ospedale Maria Vittoria, ASLTO2.
Ugo
U
Marchisio
Ricerche Statistiche ed epidemiologiche, ASLTO2.
Silvio
S
Geninatti
D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000451:nursing*; D057785:Catheters / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D020878:Device Removal / Q000451:nursing*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine; D007558:Italy; D008297:Male; D010689:Phlebitis / Q000451:nursing* / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D013503:Surgery Department, Hospital; D020246:Venous Thrombosis / Q000451:nursing* / Q000517:prevention & control