Midline vs Central Venous Catheters for Reducing Complications

Overseen By Sandeep Dhillon, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Albert Einstein College of Medicine

Must be taking: Vasopressors

Disqualifiers: Cardiac arrest, Pregnancy, Bacteremia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: Up to 28 days

100 Participants Needed

Trial Summary

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. It focuses on the use of catheters for patients requiring a vasopressor.

What data supports the effectiveness of the treatment Ultrasound Guided Central Venous Catheter and Ultrasound Guided Midline Catheter?

Research shows that using ultrasound guidance for placing central venous catheters can reduce complications, increase the success rate, and decrease the need for multiple attempts, which can make the procedure safer and more comfortable for patients. ^{1 2 3 4 5}

Is ultrasound-guided catheter placement safe for humans?

Using ultrasound to guide the placement of central and midline catheters is generally safe and reduces complications compared to older methods. It helps doctors see the veins clearly, making the procedure safer and more successful, especially in children and high-risk patients. ^{2 3 6 7 8}

How does the treatment using ultrasound-guided midline and central venous catheters differ from other treatments?

Ultrasound-guided midline and central venous catheters are unique because they use ultrasound to help place the catheter more accurately, reducing complications like infections and needle stick injuries compared to traditional methods. Midline catheters, in particular, are less invasive as they don't reach the central circulation, potentially leading to fewer complications than central venous catheters. ^{1 5 7 9 10}

What is the purpose of this trial?

The goal of this clinical trial is to learn if midline catheters can reduce adverse patient outcomes in adult patients requiring a single vasopressor. The main questions the study aims to answer are: * Do midline catheters reduce the rates of catheter-related bloodstream infections as compared to central venous catheters? * Do midline catheters reduce the rates of deep venous thrombosis as compared to central venous catheters? Researchers will compare midline catheters to central venous catheters to see if there is a reduction in these events. Participants will be randomized to the midline catheter group or the central venous catheter group. The catheters will be part of standard of care for vasopressor therapy. The participants will be followed for 30 days.

Research Team

Sandeep Dhillon, MD

Principal Investigator

Jacobi Medical Center, Albert Einstein College of Medicine

Eligibility Criteria

This trial is for adult patients who need a single vasopressor and will be receiving either a midline catheter or central venous catheter. Specific eligibility criteria are not provided, but typically participants must meet certain health conditions to ensure safety.

Inclusion Criteria

Able to provide consent (patient or health care proxy)

I need a long-term IV line for my treatment.

My arm can have a midline catheter inserted.

Exclusion Criteria

Patient expected to be discharged from the hospital within 24 hours

Prisoner

Pregnancy

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Treatment

Participants receive either a midline catheter or a central venous catheter as part of standard care for vasopressor therapy

Up to 28 days

Inpatient care

Follow-up

Participants are monitored for catheter-related complications such as bloodstream infections, thrombosis, and mechanical failures

30 days

Regular monitoring during hospital stay

Treatment Details

Interventions

• Ultrasound Guided Central Venous Catheter
• Ultrasound Guided Midline Catheter

Trial Overview The study compares the use of ultrasound-guided midline catheters with ultrasound-guided central venous catheters in adults requiring vasopressors. It aims to see if midline catheters can lower infection rates and deep vein thrombosis compared to central lines.

Participant Groups

Group I: central venous catheter Active Control 1 Intervention

If randomized to this group, patients will receive a triple lumen central venous catheter

Group II: Midline catheter Active Control 1 Intervention

If randomized to this group, patients will receive a single lumen midline catheter

Who Is Running the Clinical Trial?

Albert Einstein College of Medicine

Lead Sponsor

Trials

302

Recruited

11,690,000+

Jacobi Medical Center

Collaborator

Trials

24

Recruited

4,500+

References

1. England pubmed.ncbi.nlm.nih.gov

Incidence of catheter-related bloodstream infections following ultrasound-guided central venous catheterization: a systematic review and meta-analysis. [2022]

2. Norway pubmed.ncbi.nlm.nih.gov

[Ultrasound guidance for placement of central venous catheters]. [2016]

3. United States pubmed.ncbi.nlm.nih.gov

Cross sectional survey of ultrasound use for central venous catheter insertion among resident physicians. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Ultrasonic locating devices for central venous cannulation: meta-analysis. [2022]

5. Spain pubmed.ncbi.nlm.nih.gov

[Ultrasound-guided puncture of the jugular vein using a posterior approach]. [2019]

6. United Arab Emirates pubmed.ncbi.nlm.nih.gov

Ultrasound guided central vascular access in neonates, infants and children. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Impact of terminal tip location of midline catheters on catheter-related complications and indwelling duration in elderly patients. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Comparison of central venous catheterization with and without ultrasound guide. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Complications of Pediatric Midline Catheters: A Prospective Observational Pilot Study. [2023]

10. India pubmed.ncbi.nlm.nih.gov

Breakage and Disappearance of a Part of the Midline Catheter Tip During Insertion. [2023]