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Meta-Analysis
. 2022 May;9(3):1873-1882.
doi: 10.1002/nop2.935. Epub 2021 May 15.

The risk of venous thromboembolism associated with midline catheters compared with peripherally inserted central catheters: A systematic review and meta-analysis

Huapeng Lu  1   2 , Qinling Yang  1 , Lili Yang  1 , Kai Qu  1 , Boyan Tian  1 , Qigui Xiao  1 , Xia Xin  3 , Yi Lv  1   2 , Xuemei Zheng  3
Affiliations
Meta-Analysis

The risk of venous thromboembolism associated with midline catheters compared with peripherally inserted central catheters: A systematic review and meta-analysis

Huapeng Lu et al. Nurs Open. 2022 May.

Abstract

Background: Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause venous thromboembolism (VTE), but the prevalence associated with each is controversial.

Objective: To compare the risk of VTE between MCs and PICCs with a systematic review and meta-analysis.

Methods: The Web of Science Core Collection, PubMed, Scopus, Embase, the Cochrane Library and ProQuest were searched from inception to January 2020. All studies comparing the risk of VTE between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. Any different opinion was resolved through third-party consensus. Meta-analyses were conducted to generate estimates of VTE risk in patients with MCs versus PICCs, and publication bias was evaluated with RevMan 5.3.

Results: A total of 86 studies were identified. Twelve studies were recruited, involving 40,871 patients. The prevalence of VTE with MCs and PICCs was 3.97% (310/7806) and 2.29% (758/33065), respectively. Meta-analysis showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.53, 95% CI: 1.33-1.76, p < .00001). Subgroup analyses by age showed that the prevalence of VTE with MCs was higher than that with PICCs in the adult group (RR=1.75, 95% CI: 1.38-2.22, p < .00001), and higher than that with PICCs in the other subgroups (RR=1.42, 95% CI: 1.19-1.69, p = .0001). Subgroup analyses by nation showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.50, 95% CI: 1.30-1.73, p < .00001) in US subgroup and higher than that with PICCs (RR=2.87, 95% CI: 1.24-6.65, p = .01) in the other nations. The sensitivity analysis shows that the results from this meta-analysis are robust and all studies have no significant publication bias.

Conclusions: This study provides the first systematic assessment of the risk of VTE between MCs and PICCs. MCs are associated with a higher risk of VTE than PICCs in all patients and adults. The findings of this study have several important implications for future practice. However, the risk of VTE between MCs and PICCs in children is unclear.

Keywords: complication; intravenous therapy; midline catheter; peripherally inserted central catheter; systematic review; venous thromboembolism.

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Conflict of interest statement

None of the authors have any financial and personal relationships with other people or organizations that could inappropriately influence their work.

Figures

FIGURE 1
FIGURE 1
Summary of the literature identification and selection process
FIGURE 2
FIGURE 2
Pooled results for VTE between MCs and PICCs
FIGURE 3
FIGURE 3
Funnel plots of publication bias for VTE
See this image and copyright information in PMC

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References

    1. Al‐Asadi, O. , Almusarhed, M. , & Eldeeb, H. (2019). Predictive risk factors of venous thromboembolism (VTE) associated with peripherally inserted central catheters (PICC) in ambulant solid cancer patients: Retrospective single Centre cohort study. Thrombosis Journal, 17, 2. 10.1186/s12959-019-0191-y - DOI - PMC - PubMed
    1. Bahl, A. , Karabon, P. , & Chu, D. (2019). Comparison of venous thrombosis complications in midlines versus peripherally inserted central catheters: Are midlines the safer option?. Clinical and Applied Thrombosis/Hemostasis, 25, 1421729618. 10.1177/1076029619839150 - DOI - PMC - PubMed
    1. Benali, S. , Rypens, F. , Lacroix, J. , Dubois, J. , & Garel, L. (2013). Midline catheters versus peripherally inserted central catheters (PICC) in children: A randomized clinical trial. Pediatric Radiology, 43(S3), S541.
    1. Caparas, J. V. , & Hu, J. P. (2014). Safe administration of vancomycin through a novel midline catheter: A randomized, prospective clinical trial. The Journal of Vascular Access, 15(4), 251–256. 10.5301/jva.5000220 - DOI - PMC - PubMed
    1. Chopra, V. , Kaatz, S. , Swaminathan, L. , Boldenow, T. , Snyder, A. , Burris, R. , Bernstein, S. J. , & Flanders, S. (2019). Variation in use and outcomes related to midline catheters: Results from a multicentre pilot study. BMJ Quality & Safety, 28(9), 714–720. 10.1136/bmjqs-2018-008554 - DOI - PMC - PubMed

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