Ultrasound-guided placement of midline catheters in the surgical intensive care unit: a cost-effective proposal for timely central line removal. The Journal of Surgical Research. April 6th. [epub ahead of print].
I read this abstract with great interest. 3/31 midlines had leakage at insertion site but no doppler was mentioned for DVT examination. The leakage was considered a minor complicaiton. I believe leakage indicates a symptom of potential DVT. The overall results were good I just think I would do a doppler on the three cases.
What do you think?
kathy Kokotis
I concur Kathy. The other problem could be fibrin sheath.
Success in placing midlines does not equal successful outcomes.
I wouldn't call that research.
Darilyn
Leakage with midline catheters, particularly in The ICU setting, usually indicates chemical or mechanical phlebitis, rather than DVT. Midline catheter placement for the unstable patient often causes this due to the amount of irritants and vesicants being infused for these types of patients. Central venous access is more appropriate.
-David R. Toro
PHlebitis is the first step in the process - inflammation of the vein. But thrombophlebitis is close behind or happening at the same time. So it is difficult to separate those 2 by clinical signs and symptoms only. You would need a diagnostic ultrasound to rule out thrombophlebitis. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Agree with all the above. Would also be worried about approprietness drug related. It might be ok for some surgical procedures, for others I would worry. Just don't thinks that Midlines are the answer. Good assessment and appropriate selection of lines individualized to the patient is.
Michael Drafz RN, CRNI, VA-BC
Clinical Lead Vascular Access Service
Sharp Metropolitan Medical Campus
San Diego, CA