Impact of accelerated Seldinger technique long peripheral catheters on catheter-related outcomes: a systematic review

In recent years, the long peripheral catheter (LPC) has been introduced into clinical practice, filling the gap between short peripheral catheters and midline catheters. Heterogeneous nomenclature has created ambiguity regarding clinical outcomes.

A systematic search of CINAHL, Cochrane Library, Google Scholar, and PubMed (2000-2023) identified studies evaluating Accelerated Seldinger Technique (AST) placed LPCs in adults with difficult intravenous access (DIVA). Only Prospective and retrospective studies were included. Data extraction and quality assessment was independently performed by two authors.

Eleven studies reporting 1871 catheter placements were included, comprising eight retrospective studies, one pilot RCT, and two RCTs. Mean LPC dwell time ranged from 2.92 (±0.54) to 17.1 (±12.3) days. Reported complications included infiltration (0-24%), dysfunction (3.6-15.7%), thrombosis (0.5-15.4%), infection (0-10.2%), occlusion (0.5-10.2%), and phlebitis (0.7-9.8%). Ten studies were rated low quality and one moderate, mainly due to selection bias and inconsistent outcome reporting.

This systematic review found a moderate number of catheter-related complications for AST-placed LPCs. In patients with DIVA, AST-LPCs may provide a potentially more durable option compared with short peripheral catheters, although the evidence is limited by inconsistent reporting of therapy completion and catheter outcomes.