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I.v.-line

Question
Dear expert team,
I have had major problems with the i.v.-lines at my last i.v.-therapy; for one thing the classic i.v.-line only lasted for 2 days and perturbed me very much; for another thing the tapping with the needle was several times unsuccessful. ..
In gerenal my venes are very good and therefore I would not like to have a port for the moment.
The alternative would be a half-central i.v.-line, which I already had on the island of Amrum...unfortunately my CF-outpatient clinic does not have any experience with that!!
I hope that you could tell me some more about that in order I can pass the information on.
Many thanks,
Answer
Hello,
you wanted to know with which system so-called flow-directed catheters are used for an i.v.-therapy, as the classic peripheral i.v.-line has to be changed after a short time-interval in your case.
Those catheters are typically inserted just above or below the antecubital area; the catheter is then advanced until the tip rests in the upper arm just short of the axilla and are named "midline catheters".
One has to state generally, that the patients' sensitivity of reaction to placing an i.v.-line is very different. At the same time it is very important, that the highest level of sterility has to be kept during the procedure of placing an i.v.-line and during the later attachment and deattachment of the i.v. drugs. This is important, as an inflammation of the vene can be caused by an infection of the i.v.-line and that can make a short-term change necessary.
Furthermore it is important, that the i.v.-line is fixed very well, and is equiped with an extentsion tube, in order not to move the i.v.-line at the attachment and deattachment of drugs.
The kind of drugs given via the peripheral i.v. line have also an effect on the duration of such a line.
For a midline catheter, Deltec-catheters have standed the test. In using such catheters, the hygienic measures have to be equally respected in the strongest form.
In general it can be said, that the duration of such midline catheters, is assessed differently: some have made the experience that venes get lost to the same extent as by the usage of peripheral i.v.-lines, others state that midline catheters can remain in place longer than peripheral i.v. catheters - up to 4 weeks compared with 48-72 hours for a short peripheral catheters.
Anyway it has to been stated that the midline catheters bear a risk of thrombosis which limits their use on the other hand.
We wish you success in choosing the right form of i.v.-line in your case.
Yours sincerely,
Dr. H.-G. Posselt
20.11.2008