Performance and Safety of PowerGlide Pro® Extended Dwell Peripheral Catheters in an Emergency Medicine Unit: A Prospective Observational Study

Performance and Safety of PowerGlide Pro® Extended Dwell Peripheral Catheters in an Emergency Medicine Unit: A Prospective Observational Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Performance and Safety of PowerGlide Pro® Extended Dwell Peripheral Catheters in an Emergency Medicine Unit: A Prospective Observational Study Baudolino Mussa¹, Christian Mosca¹, Angela Restivo¹, Giulia Robasto¹, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5675245/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : The increasing complexity of hospital care has led to a growing demand for versatile vascular access devices. Extended dwell peripheral (EDP) catheters, such as the PowerGlide Pro®, have emerged as potential alternatives to both short-term peripheral and long-term central venous catheters. Objective: To evaluate the performance, safety, and efficacy of the PowerGlide Pro® EDP catheter in a sub-intensive care unit setting, comparing its outcomes to historical data on other vascular access devices. Methods : A prospective observational study was conducted on 300 patients requiring intravenous therapy for ≥7 days in the Emergency Medicine Unit at A.O.U. Città della Salute e della Scienza di Torino, Italy, from December 2019 to October 2020. Primary outcomes included complication rates, reasons for removal, and duration of catheter use. Results : Of 283 successfully placed devices, 23 complications (8.1%) were observed, with only 12 (4.2%) resulting in device removal. The average duration of catheter use was 7.26 ± 5.51 days (range: 1-31 days). Ultrasound-guided insertion was successful in 94.7% of cases. Conclusion : The PowerGlide Pro® demonstrated superior performance with a low rate of complications requiring removal compared to traditional peripheral catheters and comparable performance to midline and PICC devices. These findings suggest its potential as an effective alternative for medium-term vascular access in sub-intensive care settings. Minimidline PICC Nurse vascular access placement Midline Extended dwell peripheral catheter Vascular access devices 1. Introduction The evolution of hospital care, particularly in intensive and sub-intensive settings, has led to an increased need for reliable and versatile vascular access devices. Traditional options such as peripheral intravenous catheters (PIVCs) and central venous catheters (CVCs) each have limitations: PIVCs often require frequent replacement, while CVCs carry higher risks of serious complications [1,2]. The concept of extended dwell peripheral (EDP) catheters, also known as "midline" catheters, has gained traction as a potential solution to bridge this gap. The "0-29 Concept" represents a new approach to intra-hospital vascular access, where devices like the PowerGlide Pro® are designed to provide reliable access for up to 29 days without the complexities associated with central line placement [3,4]. Recent global events, such as the COVID-19 pandemic, have further highlighted the importance of these devices. Several guidelines, including those from SIAARTI, GAVeCeLT, and IVAS, have recommended the use of EDP catheters in COVID-19 positive patients, underscoring their growing significance in clinical practice [5,6]. The PowerGlide Pro® is an EDP catheter designed to offer several advantages: - Extended dwell time (up to 29 days) - Compatibility with a wide range of infusions - Ability to perform blood sampling - Suitability for power injection of contrast media Despite these potential benefits, there is a need for robust clinical data to evaluate the performance of such devices in real-world settings, particularly in high-acuity environments like sub-intensive care units [7,8]. This study aims to fill this knowledge gap by assessing the performance, safety, and efficacy of the PowerGlide Pro® in the Emergency Medicine Unit of a large Italian hospital. 2. Methods 2.1 Study Design and Setting We conducted a prospective observational study at the A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital site in Turin, Italy. The study was carried out in the Emergency Medicine Unit, a sub-intensive care setting, from December 2019 to October 2020. 2.2 Participants Inclusion Criteria: - Age ≥ 16 years - Anticipated need for intravenous therapy ≥ 7 days - Admission to the Emergency Medicine Unit Exclusion Criteria : - Need for immediate central venous catheter placement - Contraindications to peripheral venous catheterization - Patient refusal to participate 2.3 Device Characteristics The PowerGlide Pro® (BD BARD) specifications include: - Available sizes: 18, 20, and 22 Gauge - Lengths: 8 or 10 cm (22 Gauge only available in 8 cm) - Material: Thermosensitive polyurethane - Design: Open-ended - Special features: - Supports power injection up to 325 psi - Integrated all-in-one micro-introduction system - Nitinol guidewire in insertion handpiece 2.4 Study Protocol Staff Training All nursing staff underwent comprehensive training including: - Theoretical classroom teaching - Practical simulations - Hands-on training for blind and ultrasound-guided insertion - Device management protocols Insertion Bundle Standard equipment included: - Chloraprep BD antiseptic applicator - PowerGlide Pro® device - StatLock BD BARD fixation system - Pre-filled 10ml NaCl 0.9% syringes - Needle-free connector - Transparent semi-permeable dressing Maintenance Protocol - Daily site assessment - Dressing changes every 7 days or as needed - Standardized flushing protocol - Regular documentation of complications 2.5 Outcome Measures Primary Outcomes: - Complication rate leading to device removal - Overall complication rate - Duration of catheter use Secondary Outcomes: - First-attempt insertion success rate - Types of therapies administered - Patient comfort and satisfaction 2.6 Statistical Analysis Data were analyzed using IBM SPSS Statistics version 26. Descriptive statistics were calculated for all variables. Continuous data were expressed as mean ± standard deviation or median (interquartile range). Categorical data were presented as frequencies and percentages. Chi-square or Fisher's exact tests were used for categorical variables, and t-tests or Mann-Whitney U tests for continuous variables. P-values <0.05 were considered significant. 3. Results 3.1 Patient Characteristics Table 1 presents baseline characteristics of the 300 enrolled patients. The final analysis included 283 successful device placements. 3.2 Device Placement Outcomes The overall success rate for device placement was 94.3% (283/300). Ultrasound guidance was used in 94.7% of insertions, with a first-attempt success rate of 91.5%. 3.3 Complications During the study period, 23 complications (8.1%) were observed, with 12 (4.2%) resulting in device removal. Table 2 details the complications encountered. 3.4 Device Utilization The mean duration of catheter use was 7.26 ± 5.51 days (range: 1-31 days). Table 3 summarizes the types of therapies administered through the devices. 4. Discussion This prospective observational study provides important insights into the performance of the PowerGlide Pro® EDP catheter in a sub-intensive care setting. The key findings demonstrate several advantages over traditional vascular access devices: 1. Low Complication Rate: The 8.1% overall complication rate, with only 4.2% requiring removal, compares favorably with traditional peripheral catheters. 2. Extended Dwell Time: The mean duration of 7.26 days significantly exceeds typical PIVC duration. 3. Versatility: Successful use for multiple therapies including blood sampling, antibiotics, and power injection demonstrates broad clinical utility. 4. Safety Profile: The low incidence of serious complications suggests a favorable risk-benefit ratio. 4.1 Clinical Implications The findings suggest that the PowerGlide Pro® can effectively bridge the gap between short-term peripheral and long-term central venous access, potentially reducing the need for central line placement in many cases. 4.2 Limitations Study limitations include: - Single-center design - Lack of direct comparison group - Potential observer bias - Limited follow-up after patient transfer 4.3 Future Directions Further research should focus on: - Multi-center randomized controlled trials - Cost-effectiveness analyses - Patient-reported outcomes - Specific patient subgroup studies 5. Conclusion The PowerGlide Pro® demonstrates promising performance characteristics for medium-term vascular access in sub-intensive care settings. The low complication rates, extended dwell times, and versatility support its role in a comprehensive vascular access strategy. Declarations Funding This research received no external funding. All resources were provided through standard hospital operating budgets. Competing Interests The authors declare no competing interests. The PowerGlide Pro® devices used in this study were acquired through standard hospital procurement channels, and no funding or material support was received from BD BARD. Ethics Approval This study was performed in accordance with the Declaration of Helsinki and approved by the Ethics Committee of A.O.U. Città della Salute e della Scienza di Torino (approval number [insert number]). Consent to Participate Informed consent was obtained from all individual participants included in the study or their legal representatives. Consent to Publish Patients signed informed consent regarding publishing their data. No identifying information is included in this article. Data Availability The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Author Contributions - Conceptualization: Mussa Baudolino - Methodology: Mussa Baudolino, Christian Mosca - Formal analysis: Emanuele Pivetta - Investigation: Giulia Robasto, Angela Restivo - Writing - original draft: Mussa Baudolino - Writing - review & editing: All authors - Supervision: Enrico Lupia Acknowledgments The authors would like to thank the nursing staff of the Emergency Medicine Unit for their dedication and support in implementing the study protocol. We also acknowledge the support of the hospital's Vascular Access Team for their assistance with staff training. Funding Information This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Large Language Model Statement No large language models were used in the preparation of this manuscript. Ethical committee approval 026276 in Turin the 13 th March 2018 Conflict of Interest Statement The authors declare that they have no conflict of interest. All devices used in this study were acquired through standard hospital procurement channels with no external support from manufacturers or suppliers. References Alexandrou E, Ray-Barruel G, Carr PJ, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5):328-334. https://doi.org/10.12788/jhm.3039 Chopra V, Flanders SA, Saint S, et al. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method. Ann Intern Med. 2015;163(6_Supplement):S1-S40. https://doi.org/10.7326/M15-0744 Pittiruti M, Scoppettuolo G. The GAVeCeLT manual of PICC and midline: Indications, insertion, management. Edra S.p.A.; 2017. Moureau N, Chopra V. 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A clinical pathway for the management of difficult venous access. BMC Nurs. 2017;16:64. https://doi.org/10.1186/s12912-017-0261-z van Loon FHJ, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA Scale: A Clinical Predictive Scale to Identify Difficult Intravenous Access in Adult Patients Based on Clinical Observations. Medicine (Baltimore). 2016;95(16):e3428. https://doi.org/10.1097/MD.0000000000003428 Adams DZ, Little A, Vinsant C, Khandelwal S. The Midline Catheter: A Clinical Review. J Emerg Med. 2016;51(3):252-258. https://doi.org/10.1016/j.jemermed.2016.05.029 Caparas JV, Hu JP. Safe administration of vancomycin through a novel midline catheter: a randomized, prospective clinical trial. J Vasc Access. 2014;15(4):251-256. https://doi.org/10.5301/jva.5000220 DeVries M, Valentine M, Mancos P. Protected Clinical Indication of Peripheral Intravenous Lines: Successful Implementation. J Assoc Vasc Access. 2016;21(2):89-92. https://doi.org/10.1016/j.java.2016.03.001 Gibbons CL, Gale M, Gorski LA, et al. The Maki Scoring System: A Comparative Study of Infusion-Related Cost, Morbidity, and Complications in Patients with Peripheral Intravenous Catheters and Midline Catheters. J Infus Nurs. 2020;43(3):144-150. https://doi.org/10.1097/NAN.0000000000000367 Pittiruti M, Scoppettuolo G, Emoli A, et al. Clinical experience with a new ultrasound-guided peripheral venous access device: the P-CATH®. J Vasc Access. 2019;20(3):325-329. https://doi.org/10.1177/1129729818805956 Spencer TR, Mahoney KJ. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio. J Thromb Thrombolysis. 2017;44(4):427-434. https://doi.org/10.1007/s11239-017-1569-y Ullman AJ, Chopra V, Brown E, et al. Developing appropriateness criteria for pediatric vascular access. Pediatrics. 2020;145(Suppl 3):S233-S242. https://doi.org/10.1542/peds.2019-3474I Lapostolle F, Catineau J, Garrigue B, et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007;33(8):1452-1457. https://doi.org/10.1007/s00134-007-0634-y Carr PJ, Rippey JC, Budgeon CA, et al. Insertion of peripheral intravenous cannulae in the Emergency Department: factors associated with first-time insertion success. J Vasc Access. 2016;17(2):182-190. https://doi.org/10.5301/jva.5000487 Murayama R, Uchida M, Oe M, et al. Removal of Peripheral Intravenous Catheters Due to Catheter Failures Among Adult Patients. J Infus Nurs. 2017;40(4):224-231. https://doi.org/10.1097/NAN.0000000000000168 Marsh N, Webster J, Mihala G, Rickard CM. Devices and dressings to secure peripheral venous catheters to prevent complications. Cochrane Database Syst Rev. 2015;2015(6):CD011070. https://doi.org/10.1002/14651858.CD011070.pub2 Alexandrou E, Ray-Barruel G, Carr PJ, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5). https://doi.org/10.12788/jhm.3039 Hallam C, Weston V, Denton A, et al. Development of the UK Vessel Health and Preservation (VHP) framework: a multi-organisational collaborative. J Infect Prev. 2016;17(2):65-72. https://doi.org/10.1177/1757177415624752 Takashima M, Ray-Barruel G, Ullman A, Keogh S, Rickard CM. Randomized controlled trials in central vascular access devices: A scoping review. PLoS One. 2017;12(3):e0174164. https://doi.org/10.1371/journal.pone.0174164 Blanco-Mavillard I, Rodríguez-Calero MÁ, de Pedro-Gómez J, et al. Incidence of peripheral intravenous catheter failure among inpatients: variability between microbiological data and clinical signs and symptoms. Antimicrob Resist Infect Control. 2019;8:124. https://doi.org/10.1186/s13756-019-0581-8 Cooke M, Ullman AJ, Ray-Barruel G, Wallis M, Corley A, Rickard CM. Not "just" an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries. PLoS One. 2018;13(2):e0193436. https://doi.org/10.1371/journal.pone.0193436 Tables Tables 1 to 3 are available in the Supplementary Files section Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5675245","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":396156820,"identity":"4e2c9832-2499-49ef-b0b5-486190c20b5d","order_by":0,"name":"Baudolino Mussa¹","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYBACAyCWYCiQgAvIMTAwNoAF8WsxQCgwBmppBOqRwKkHqgUhkNhAyBpz9jOGNz4YWOTxM3CnSf74Y5e+4XZz+4MPDBZ1uLRY9uQYW84wkCiWbODdJs3blpy74c7BxsYZ+Bx2IMdMmsdAInHDAaAWxgbm3A03EhubefBpOf8GoQXosPp0A4JabiDZIsHDdjiBoBbLGc+KQX5JnNnMu9mat+244UyglplAEckGHFrM+ZM33vhQUZfYz9678eaPP9XyfDfSH3wAivDjsgUBmFEdTFjDKBgFo2AUjALcAABEhVJHLUzdKgAAAABJRU5ErkJggg==","orcid":"","institution":"University of Turin","correspondingAuthor":true,"prefix":"","firstName":"Baudolino","middleName":"","lastName":"Mussa¹","suffix":""},{"id":396156821,"identity":"051ea7cf-7f50-4e6c-8f38-a4382b15c800","order_by":1,"name":"Christian Mosca¹","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Christian","middleName":"","lastName":"Mosca¹","suffix":""},{"id":396156822,"identity":"63effe9b-845f-40ad-a9da-b55259e13aeb","order_by":2,"name":"Angela Restivo¹","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Angela","middleName":"","lastName":"Restivo¹","suffix":""},{"id":396156823,"identity":"519c787f-84a5-4b07-b744-12e1dbc1821e","order_by":3,"name":"Giulia Robasto¹","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Giulia","middleName":"","lastName":"Robasto¹","suffix":""},{"id":396156824,"identity":"28e2694d-5188-4633-8107-8fd7ada0e2e0","order_by":4,"name":"Emanuele Pivetta¹","email":"","orcid":"","institution":"A.O.U. 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Introduction","content":"\u003cp\u003eThe evolution of hospital care, particularly in intensive and sub-intensive settings, has led to an increased need for reliable and versatile vascular access devices. Traditional options such as peripheral intravenous catheters (PIVCs) and central venous catheters (CVCs) each have limitations: PIVCs often require frequent replacement, while CVCs carry higher risks of serious complications [1,2].\u003c/p\u003e\n\u003cp\u003eThe concept of extended dwell peripheral (EDP) catheters, also known as \"midline\" catheters, has gained traction as a potential solution to bridge this gap. The \"0-29 Concept\" represents a new approach to intra-hospital vascular access, where devices like the PowerGlide Pro® are designed to provide reliable access for up to 29 days without the complexities associated with central line placement [3,4].\u003c/p\u003e\n\u003cp\u003eRecent global events, such as the COVID-19 pandemic, have further highlighted the importance of these devices. Several guidelines, including those from SIAARTI, GAVeCeLT, and IVAS, have recommended the use of EDP catheters in COVID-19 positive patients, underscoring their growing significance in clinical practice [5,6].\u003c/p\u003e\n\u003cp\u003eThe PowerGlide Pro® is an EDP catheter designed to offer several advantages:\u003c/p\u003e\n\u003cp\u003e- Extended dwell time (up to 29 days)\u003c/p\u003e\n\u003cp\u003e- Compatibility with a wide range of infusions\u003c/p\u003e\n\u003cp\u003e- Ability to perform blood sampling\u003c/p\u003e\n\u003cp\u003e- Suitability for power injection of contrast media\u003c/p\u003e\n\u003cp\u003eDespite these potential benefits, there is a need for robust clinical data to evaluate the performance of such devices in real-world settings, particularly in high-acuity environments like sub-intensive care units [7,8]. This study aims to fill this knowledge gap by assessing the performance, safety, and efficacy of the PowerGlide Pro® in the Emergency Medicine Unit of a large Italian hospital.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study Design and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe conducted a prospective observational study at the A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital site in Turin, Italy. The study was carried out in the Emergency Medicine Unit, a sub-intensive care setting, from December 2019 to October 2020.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInclusion Criteria:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- Age ≥ 16 years\u003c/p\u003e\n\u003cp\u003e- Anticipated need for intravenous therapy ≥ 7 days\u003c/p\u003e\n\u003cp\u003e- Admission to the Emergency Medicine Unit\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eExclusion Criteria\u003c/em\u003e:\u003c/p\u003e\n\u003cp\u003e- Need for immediate central venous catheter placement\u003c/p\u003e\n\u003cp\u003e- Contraindications to peripheral venous catheterization\u003c/p\u003e\n\u003cp\u003e- Patient refusal to participate\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Device Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PowerGlide Pro® (BD BARD) specifications include:\u003c/p\u003e\n\u003cp\u003e- Available sizes: 18, 20, and 22 Gauge\u003c/p\u003e\n\u003cp\u003e- Lengths: 8 or 10 cm (22 Gauge only available in 8 cm)\u003c/p\u003e\n\u003cp\u003e- Material: Thermosensitive polyurethane\u003c/p\u003e\n\u003cp\u003e- Design: Open-ended\u003c/p\u003e\n\u003cp\u003e- Special features:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; - Supports power injection up to 325 psi\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; - Integrated all-in-one micro-introduction system\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; - Nitinol guidewire in insertion handpiece\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Study Protocol\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStaff Training\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll nursing staff underwent comprehensive training including:\u003c/p\u003e\n\u003cp\u003e- Theoretical classroom teaching\u003c/p\u003e\n\u003cp\u003e- Practical simulations\u003c/p\u003e\n\u003cp\u003e- Hands-on training for blind and ultrasound-guided insertion\u003c/p\u003e\n\u003cp\u003e- Device management protocols\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInsertion Bundle\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStandard equipment included:\u003c/p\u003e\n\u003cp\u003e- Chloraprep BD antiseptic applicator\u003c/p\u003e\n\u003cp\u003e- PowerGlide Pro® device\u003c/p\u003e\n\u003cp\u003e- StatLock BD BARD fixation system\u003c/p\u003e\n\u003cp\u003e- Pre-filled 10ml NaCl 0.9% syringes\u003c/p\u003e\n\u003cp\u003e- Needle-free connector\u003c/p\u003e\n\u003cp\u003e- Transparent semi-permeable dressing\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMaintenance Protocol\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- Daily site assessment\u003c/p\u003e\n\u003cp\u003e- Dressing changes every 7 days or as needed\u003c/p\u003e\n\u003cp\u003e- Standardized flushing protocol\u003c/p\u003e\n\u003cp\u003e- Regular documentation of complications\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Outcome Measures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePrimary Outcomes:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- Complication rate leading to device removal\u003c/p\u003e\n\u003cp\u003e- Overall complication rate\u003c/p\u003e\n\u003cp\u003e- Duration of catheter use\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSecondary Outcomes:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- First-attempt insertion success rate\u003c/p\u003e\n\u003cp\u003e- Types of therapies administered\u003c/p\u003e\n\u003cp\u003e- Patient comfort and satisfaction\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Statistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using IBM SPSS Statistics version 26. Descriptive statistics were calculated for all variables. Continuous data were expressed as mean\u0026nbsp;±\u0026nbsp;standard deviation or median (interquartile range). Categorical data were presented as frequencies and percentages. Chi-square or Fisher's exact tests were used for categorical variables, and t-tests or Mann-Whitney U tests for continuous variables. P-values \u0026lt;0.05 were considered significant.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Patient Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 presents baseline characteristics of the 300 enrolled patients. The final analysis included 283 successful device placements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Device Placement Outcomes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe overall success rate for device placement was 94.3% (283/300). Ultrasound guidance was used in 94.7% of insertions, with a first-attempt success rate of 91.5%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the study period, 23 complications (8.1%) were observed, with 12 (4.2%) resulting in device removal. Table 2 details the complications encountered.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Device Utilization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean duration of catheter use was 7.26 \u0026plusmn; 5.51 days (range: 1-31 days). Table 3 summarizes the types of therapies administered through the devices.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis prospective observational study provides important insights into the performance of the PowerGlide Pro® EDP catheter in a sub-intensive care setting. The key findings demonstrate several advantages over traditional vascular access devices:\u003c/p\u003e\n\u003cp\u003e1. Low Complication Rate: The 8.1% overall complication rate, with only 4.2% requiring removal, compares favorably with traditional peripheral catheters.\u003c/p\u003e\n\u003cp\u003e2. Extended Dwell Time: The mean duration of 7.26 days significantly exceeds typical PIVC duration.\u003c/p\u003e\n\u003cp\u003e3. Versatility: Successful use for multiple therapies including blood sampling, antibiotics, and power injection demonstrates broad clinical utility.\u003c/p\u003e\n\u003cp\u003e4. Safety Profile: The low incidence of serious complications suggests a favorable risk-benefit ratio.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.1 Clinical Implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings suggest that the PowerGlide Pro® can effectively bridge the gap between short-term peripheral and long-term central venous access, potentially reducing the need for central line placement in many cases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy limitations include:\u003c/p\u003e\n\u003cp\u003e- Single-center design\u003c/p\u003e\n\u003cp\u003e- Lack of direct comparison group\u003c/p\u003e\n\u003cp\u003e- Potential observer bias\u003c/p\u003e\n\u003cp\u003e- Limited follow-up after patient transfer\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3 Future Directions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFurther research should focus on:\u003c/p\u003e\n\u003cp\u003e- Multi-center randomized controlled trials\u003c/p\u003e\n\u003cp\u003e- Cost-effectiveness analyses\u003c/p\u003e\n\u003cp\u003e- Patient-reported outcomes\u003c/p\u003e\n\u003cp\u003e- Specific patient subgroup studies\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe PowerGlide Pro® demonstrates promising performance characteristics for medium-term vascular access in sub-intensive care settings. The low complication rates, extended dwell times, and versatility support its role in a comprehensive vascular access strategy.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no external funding. All resources were provided through standard hospital operating budgets.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests. The PowerGlide Pro® devices used in this study were acquired through standard hospital procurement channels, and no funding or material support was received from BD BARD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the Declaration of Helsinki and approved by the Ethics Committee of A.O.U. Città della Salute e della Scienza di Torino (approval number [insert number]).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study or their legal representatives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients signed informed consent regarding publishing their data. No identifying information is included in this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e- Conceptualization: Mussa Baudolino\u003c/p\u003e\n\u003cp\u003e- Methodology: Mussa Baudolino, Christian Mosca\u003c/p\u003e\n\u003cp\u003e- Formal analysis: Emanuele Pivetta\u003c/p\u003e\n\u003cp\u003e- Investigation: Giulia Robasto, Angela Restivo\u003c/p\u003e\n\u003cp\u003e- Writing - original draft: Mussa Baudolino\u003c/p\u003e\n\u003cp\u003e- Writing - review \u0026amp; editing: All authors\u003c/p\u003e\n\u003cp\u003e- Supervision: Enrico Lupia\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the nursing staff of the Emergency Medicine Unit for their dedication and support in implementing the study protocol. We also acknowledge the support of the hospital\u0026apos;s Vascular Access Team for their assistance with staff training.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLarge Language Model Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo large language models were used in the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical committee approval 026276 in Turin the 13\u003csup\u003eth\u003c/sup\u003e March 2018\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest. All devices used in this study were acquired through standard hospital procurement channels with no external support from manufacturers or suppliers.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlexandrou E, Ray-Barruel G, Carr PJ, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5):328-334. https://doi.org/10.12788/jhm.3039\u003c/li\u003e\n\u003cli\u003eChopra V, Flanders SA, Saint S, et al. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method. Ann Intern Med. 2015;163(6_Supplement):S1-S40. https://doi.org/10.7326/M15-0744\u003c/li\u003e\n\u003cli\u003ePittiruti M, Scoppettuolo G. The GAVeCeLT manual of PICC and midline: Indications, insertion, management. Edra S.p.A.; 2017.\u003c/li\u003e\n\u003cli\u003eMoureau N, Chopra V. 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BMJ Qual Saf. 2019;28(9):714-720. https://doi.org/10.1136/bmjqs-2018-008554\u003c/li\u003e\n\u003cli\u003eWallis MC, McGrail M, Webster J, et al. Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infect Control Hosp Epidemiol. 2014;35(1):63-68. https://doi.org/10.1086/674398\u003c/li\u003e\n\u003cli\u003eMiliani K, Taravella R, Thillard D, et al. Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project). PLoS One. 2017;12(1):e0168637. https://doi.org/10.1371/journal.pone.0168637\u003c/li\u003e\n\u003cli\u003eHelm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189-203. https://doi.org/10.1097/NAN.0000000000000100\u003c/li\u003e\n\u003cli\u003eCampagna S, Gonella S, Zerla PA, et al. 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Br J Nurs. 2016;25(8):S15-S24. https://doi.org/10.12968/bjon.2016.25.8.S15\u003c/li\u003e\n\u003cli\u003eMarsh N, Webster J, Larson E, Cooke M, Mihala G, Rickard CM. Observational Study of Peripheral Intravenous Catheter Outcomes in Adult Hospitalized Patients: A Multivariable Analysis of Peripheral Intravenous Catheter Failure. J Hosp Med. 2018;13(2):83-89. https://doi.org/10.12788/jhm.2867\u003c/li\u003e\n\u003cli\u003eChopra V, O\u0026apos;Horo JC, Rogers MA, Maki DG, Safdar N. The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2013;34(9):908-918. https://doi.org/10.1086/671737\u003c/li\u003e\n\u003cli\u003eParienti JJ, Mongardon N, M\u0026eacute;garbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015;373(13):1220-1229. https://doi.org/10.1056/NEJMoa1500964\u003c/li\u003e\n\u003cli\u003eSou V, McManus C, Mifflin N, Frost SA, Ale J, Alexandrou E. A clinical pathway for the management of difficult venous access. BMC Nurs. 2017;16:64. https://doi.org/10.1186/s12912-017-0261-z\u003c/li\u003e\n\u003cli\u003evan Loon FHJ, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA Scale: A Clinical Predictive Scale to Identify Difficult Intravenous Access in Adult Patients Based on Clinical Observations. Medicine (Baltimore). 2016;95(16):e3428. https://doi.org/10.1097/MD.0000000000003428\u003c/li\u003e\n\u003cli\u003eAdams DZ, Little A, Vinsant C, Khandelwal S. The Midline Catheter: A Clinical Review. J Emerg Med. 2016;51(3):252-258. https://doi.org/10.1016/j.jemermed.2016.05.029\u003c/li\u003e\n\u003cli\u003eCaparas JV, Hu JP. Safe administration of vancomycin through a novel midline catheter: a randomized, prospective clinical trial. J Vasc Access. 2014;15(4):251-256. https://doi.org/10.5301/jva.5000220\u003c/li\u003e\n\u003cli\u003eDeVries M, Valentine M, Mancos P. Protected Clinical Indication of Peripheral Intravenous Lines: Successful Implementation. J Assoc Vasc Access. 2016;21(2):89-92. https://doi.org/10.1016/j.java.2016.03.001\u003c/li\u003e\n\u003cli\u003eGibbons CL, Gale M, Gorski LA, et al. The Maki Scoring System: A Comparative Study of Infusion-Related Cost, Morbidity, and Complications in Patients with Peripheral Intravenous Catheters and Midline Catheters. J Infus Nurs. 2020;43(3):144-150. https://doi.org/10.1097/NAN.0000000000000367\u003c/li\u003e\n\u003cli\u003ePittiruti M, Scoppettuolo G, Emoli A, et al. Clinical experience with a new ultrasound-guided peripheral venous access device: the P-CATH\u0026reg;. J Vasc Access. 2019;20(3):325-329. https://doi.org/10.1177/1129729818805956\u003c/li\u003e\n\u003cli\u003eSpencer TR, Mahoney KJ. Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio. J Thromb Thrombolysis. 2017;44(4):427-434. https://doi.org/10.1007/s11239-017-1569-y\u003c/li\u003e\n\u003cli\u003eUllman AJ, Chopra V, Brown E, et al. Developing appropriateness criteria for pediatric vascular access. Pediatrics. 2020;145(Suppl 3):S233-S242. https://doi.org/10.1542/peds.2019-3474I\u003c/li\u003e\n\u003cli\u003eLapostolle F, Catineau J, Garrigue B, et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007;33(8):1452-1457. https://doi.org/10.1007/s00134-007-0634-y\u003c/li\u003e\n\u003cli\u003eCarr PJ, Rippey JC, Budgeon CA, et al. Insertion of peripheral intravenous cannulae in the Emergency Department: factors associated with first-time insertion success. J Vasc Access. 2016;17(2):182-190. https://doi.org/10.5301/jva.5000487\u003c/li\u003e\n\u003cli\u003eMurayama R, Uchida M, Oe M, et al. Removal of Peripheral Intravenous Catheters Due to Catheter Failures Among Adult Patients. J Infus Nurs. 2017;40(4):224-231. https://doi.org/10.1097/NAN.0000000000000168\u003c/li\u003e\n\u003cli\u003eMarsh N, Webster J, Mihala G, Rickard CM. Devices and dressings to secure peripheral venous catheters to prevent complications. Cochrane Database Syst Rev. 2015;2015(6):CD011070. https://doi.org/10.1002/14651858.CD011070.pub2\u003c/li\u003e\n\u003cli\u003eAlexandrou E, Ray-Barruel G, Carr PJ, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5). https://doi.org/10.12788/jhm.3039\u003c/li\u003e\n\u003cli\u003eHallam C, Weston V, Denton A, et al. Development of the UK Vessel Health and Preservation (VHP) framework: a multi-organisational collaborative. J Infect Prev. 2016;17(2):65-72. https://doi.org/10.1177/1757177415624752\u003c/li\u003e\n\u003cli\u003eTakashima M, Ray-Barruel G, Ullman A, Keogh S, Rickard CM. Randomized controlled trials in central vascular access devices: A scoping review. PLoS One. 2017;12(3):e0174164. https://doi.org/10.1371/journal.pone.0174164\u003c/li\u003e\n\u003cli\u003eBlanco-Mavillard I, Rodr\u0026iacute;guez-Calero M\u0026Aacute;, de Pedro-G\u0026oacute;mez J, et al. Incidence of peripheral intravenous catheter failure among inpatients: variability between microbiological data and clinical signs and symptoms. Antimicrob Resist Infect Control. 2019;8:124. https://doi.org/10.1186/s13756-019-0581-8\u003c/li\u003e\n\u003cli\u003eCooke M, Ullman AJ, Ray-Barruel G, Wallis M, Corley A, Rickard CM. Not \u0026quot;just\u0026quot; an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries. PLoS One. 2018;13(2):e0193436. https://doi.org/10.1371/journal.pone.0193436\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Minimidline, PICC, Nurse vascular access placement, Midline, Extended dwell peripheral catheter, Vascular access devices ","lastPublishedDoi":"10.21203/rs.3.rs-5675245/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5675245/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: The increasing complexity of hospital care has led to a growing demand for versatile vascular access devices. Extended dwell peripheral (EDP) catheters, such as the PowerGlide Pro®, have emerged as potential alternatives to both short-term peripheral and long-term central venous catheters.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To evaluate the performance, safety, and efficacy of the PowerGlide Pro® EDP catheter in a sub-intensive care unit setting, comparing its outcomes to historical data on other vascular access devices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A prospective observational study was conducted on 300 patients requiring intravenous therapy for ≥7 days in the Emergency Medicine Unit at A.O.U. Città della Salute e della Scienza di Torino, Italy, from December 2019 to October 2020. Primary outcomes included complication rates, reasons for removal, and duration of catheter use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Of 283 successfully placed devices, 23 complications (8.1%) were observed, with only 12 (4.2%) resulting in device removal. The average duration of catheter use was 7.26 ± 5.51 days (range: 1-31 days). Ultrasound-guided insertion was successful in 94.7% of cases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The PowerGlide Pro® demonstrated superior performance with a low rate of complications requiring removal compared to traditional peripheral catheters and comparable performance to midline and PICC devices. These findings suggest its potential as an effective alternative for medium-term vascular access in sub-intensive care settings.\u003c/p\u003e","manuscriptTitle":"Performance and Safety of PowerGlide Pro® Extended Dwell Peripheral Catheters in an Emergency Medicine Unit: A Prospective Observational Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-03 16:39:34","doi":"10.21203/rs.3.rs-5675245/v1","editorialEvents":[{"type":"communityComments","content":2}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a6e1e64a-ca1a-490c-bbf4-8399fc9dcfdd","owner":[],"postedDate":"January 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-05T06:23:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-03 16:39:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5675245","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5675245","identity":"rs-5675245","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}