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The risk of venous thromboembolism associated with midline catheters compared with peripherally inserted central

Huapeng Lu1,2, Qinling Yang1, Lili Yang1

  • 1Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.

Nursing Open
|May 15, 2021
PubMed
Abstract

Insights

Midline catheters (MCs) pose a higher risk of venous thromboembolism (VTE) compared to peripherally inserted central catheters (PICCs) in adults. This systematic review and meta-analysis highlights the increased VTE prevalence associated with MCs, informing clinical practice.

Area of Science:

  • Medical devices
  • Vascular access
  • Thromboembolism

Background:

  • Venous thromboembolism (VTE) is a known complication of both midline catheters (MCs) and peripherally inserted central catheters (PICCs).
  • The comparative prevalence of VTE between these two types of catheters remains controversial in existing literature.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis to compare the risk of VTE associated with MCs versus PICCs.
  • To provide a comprehensive assessment of VTE prevalence for each catheter type.

Main Methods:

  • Systematic literature search across multiple databases (Web of Science, PubMed, Scopus, Embase, Cochrane Library, ProQuest) up to January 2020.
  • Inclusion of studies comparing VTE risk between MCs and PICCs, with methodological quality assessed using the Downs and Black checklist.
  • Meta-analysis to estimate VTE risk and evaluate publication bias using RevMan 5.3.

Main Results:

  • Twelve studies involving 40,871 patients were analyzed, revealing a VTE prevalence of 3.97% for MCs and 2.29% for PICCs.
  • Meta-analysis indicated a significantly higher prevalence of VTE with MCs compared to PICCs (RR=1.53, p < .00001).
  • Subgroup analyses confirmed higher VTE risk with MCs in adults and across different nations, with robust findings and no significant publication bias.

Conclusions:

  • This study is the first systematic assessment comparing VTE risk between MCs and PICCs.
  • Midline catheters are associated with a significantly higher risk of VTE than PICCs, particularly in adult populations.
  • Further research is needed to clarify the VTE risk associated with these catheters in pediatric patients.
Keywords:
complicationintravenous therapymidline catheterperipherally inserted central cathetersystematic reviewvenous thromboembolism

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