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Risk of midline catheter-related thrombosis due to catheter diameter: An observational cohort study

Amit Bahl1, Nicholas Mielke2, Yuying Xing3

  • 1Department of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States of America.

Thrombosis Research
|June 18, 2023
PubMed

Insights

Choosing smaller diameter midline catheters (MC) can reduce the risk of deep vein thrombosis (DVT). Larger 5 Fr MCs significantly increase DVT odds, while catheter size and catheter-to-vein ratio show similar predictive accuracy for DVT.

Area of Science:

  • Vascular Medicine
  • Medical Devices
  • Thrombosis Research

Background:

  • Deep vein thrombosis (DVT) is a significant complication associated with midline catheters (MC).
  • Understanding risk factors for MC-associated DVT is crucial for patient safety.

Purpose of the Study:

  • To investigate the relationship between midline catheter diameter and the incidence of deep vein thrombosis.
  • To compare the predictive accuracy of catheter size versus catheter-to-vein ratio for DVT development.

Main Methods:

  • An observational cohort study was conducted with 3088 hospitalized adults requiring midline catheters.
  • Participants were categorized by catheter diameter (3 Fr, 4 Fr, 5 Fr).
  • Outcomes included symptomatic upper extremity DVT, with analysis of catheter size and catheter-to-vein ratio.

Main Results:

  • DVT incidence varied significantly by catheter size: 4.4% for 3 Fr, 3.9% for 4 Fr, and 11.9% for 5 Fr (p < 0.001).
  • Multivariable analysis revealed significantly higher odds of DVT for 5 Fr MCs (aOR 2.72) compared to 3 Fr.
  • Each additional day of catheter use increased DVT odds by 3% (aOR 1.03).

Conclusions:

  • Preferential selection of smaller diameter midline catheters (e.g., 3 Fr or 4 Fr) is recommended to minimize DVT risk.
  • Both catheter size and a 1:3 catheter-to-vein ratio threshold demonstrate comparable accuracy in predicting DVT.
Abstract

Keywords:
Catheter related thrombosisCatheter to vein ratioComplicationsDeep vein thrombosisDiameterGaugeMidline catheterThrombosis

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