Albert Einstein College of Medicine
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.
Within the United States, around 5 million central venous catheters (CVCs) and 150 million peripheral catheters are inserted annually. A 2015 surveillance survey across 10 U.S. states revealed that 4% of hospitalized patients had 1 or more healthcare-associated infections, with 25.6% reported as device-associated infections. Device-associated infections included catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infections, and ventilator-associated pneumonia. In addition to increased rates of CRBSI, CVCs are associated with upper extremity deep venous thrombosis…
Inclusion Criteria: * Patients over 18 years of age being treated in the Emergency Department at Jacobi Medical Center * Have an upper extremity (left or right arm) that can accept a midline catheter * Able to provide consent (patient or health care proxy) * Clinical team believes the patient will require inpatient admission at the time of needing intravenous access * Requires a central line or midline catheter as an expected requirement of care * Patients requiring a single vasopressor due to hypotension Exclusion Criteria: * Patients in cardiac arrest (prior to achieving ROSC) *…
Patients randomized to this arm will receive an ultrasound guided central venous catheter. The catheter is 20cm in length.
Patients randomized to this arm will receive an ultrasound guided midline catheter. The catheter is 8-10cm in length.
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