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recruitment problem
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The study will evaluate 2 strategies to remove central venous catheter (CVC): in one part, the insertion of a midline catheter and in the other part, the conventional insertion of peripheral venous catheter (PVC)
Patients will be randomised when the last indication for CVC has disappeared, which means parenteral nutrition or vasopressors administration.
They will be randomised either in the midline group or in the PVC group.
If successful, CVC will then be removed. If not, a PVC will try to be inserted daily till success or worthlessness of a venous line or death.
The presence of a CVC will be assessed at the 96th hour after disappearance of last CVC indication.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Midline Catheter | Active Comparator | Pt. will receive midline catheters. |
|
| Standard Peripheral venous Catheter | Active Comparator | Pt. will receive a standard Peripheral venous catheter |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Midline | Device | Patient will receive a Midline catheter within 48h after disappearance of indication for CVC |
|
| Measure | Description | Time Frame |
|---|---|---|
| % of patient with a successful Removal of CVC at the 96th hour after disappearance of last indication for CVC | A successful removal of CVC is defined as
| H96 : 96th hour after disappearance of last indication for CVC |
| Measure | Description | Time Frame |
|---|---|---|
| Total number of puncture required for the insertion of a peripheral catheter | until 28 days after randomisation | |
| Total number of peripheral catheter used | until 28 days after randomisation | |
| Measure | Description | Time Frame |
|---|---|---|
| Colonization of Midline at removal | swabbing will be performed at catheter removal and its tips will be also analyzed | until removal,an expected average of 10 days after insertion |
| Colonization of skin at insert point of Midline catheter |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| angelina robert | CHD vendee | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Departemental Vendée | La Roche-sur-Yon | 85925 | France |
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supportive care
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| PVC | Device | Patient will receive a standard PVC within 48h after disappearance of indication for CVC |
|
|
| Number of new CVC inserted |
| until 28 days after randomisation |
| Time consumption | Total time of catheterisation, (measured from the entrance in patient room, to the exit) | until 28 days after randomisation |
| Number of blood culture for research of catheter-related bloodstream infection (CRBSI) | until 28 days after randomisation |
| CVC dwell time | Time of central catheter duration (hours) | from disappearance of CVC indication to last CVC removal or 28 days after randomisation if still in place |
| Number of CVC colonized for per 1000 CVC /days | until 28 days after randomisation |
| Number of CVC-associated bacteremia | until 28 days after randomisation |
| Number of peripheral catheter-associated bacteremia | until 28 days after randomisation |
| ICU length of stay | Until discharge from ICU, an expected average of 12 days |
| Hospital length of stay | Hospital stay in medical and surgical unit (no follow-up and rehabilitation care unit or long stay) | Until discharge from hospital, an expected average of 20 days |
| ICU mortality | Until discharge from ICU, an expected average of 12 days |
| hospital mortality | mortality in medical and surgical unit (no SSR or long stay) | Until discharge from hospital, an expected average of 20 days |
swabbing will be performed at every change of dressing
| until 28 days after randomisation |
| Thrombosis at Midline removal | thrombosis will be checked by ultrasound-echography if midline is removed in ICU | until removal in ICU,an expected average of 10 days after insertion |