India Peripheral Catheters Market Size Share Analysis 2022-2029

India Peripheral Catheters Market Size Share Analysis 2022-2029

India Peripheral Catheters Market is expected to grow at a high CAGR 6.5% during the forecasting period (2022-2029).

2021-06-15

All the neighboring countries of India have reported positive COVID-19 cases. To protect against the deadly virus, the Indian government has taken necessary and strict measures, including establishing health check posts between the national borders to test whether people entering the country have the virus. The health emergency owing to the COVID-19 pandemic has led to a series of dramatic changes in the routine of the clinical practice, requiring the revision of several decision-making processes, the reorganization of treatment units, and the reformulation of protocols and procedures.

In the practice of venous access - which is essential for the appropriate treatment of COVID-19 patients - it was necessary to review the criteria for the selection, insertion and maintenance of the various devices currently present in the hospitals.

In the COVID-19 patient in ICU, a central venous access: PICC, FICC (femorally inserted central catheter), or CICC (centrally inserted central catheter) is recommended.

In the COVID-19 patient who does not require admission to intensive care unit (ICU), use a peripheral venous access device; prefer a long peripheral cannula (a.k.a. “mini-Midline,” 6–15 cm) or a standard midline catheter (15–25 cm) rather than a short cannula (< 6 cm). Due to their longer dwell time, midline catheters will reduce the number of peripheral venous insertions required (thus saving resources and reducing risks for the operator); they will allow high flow infusions and easy blood sampling; if indicated, they might be easily replaced over guidewire with a peripherally inserted central catheter (PICC).

Use of ultrasound guidance for the insertion of any central venous access or midline catheter or peripheral arterial catheter is highly recommended. As the risk of central venous catheter dislodgment is particularly high in the COVID-19 patient, particularly during the maneuvers of pronation-supination, consider the use of subcutaneously anchored securement.

Ultrasound-guided insertion of long peripheral catheters (also called 'mini-Midline', 6-15 cm) may play a role, albeit limited, in these patients, for example on arrival in the emergency room. If compared to Midlines, the advantages of mini-Midlines - lower cost and simpler insertion – should be weighed against the shorter dwell time, the higher risk for local complications (dislocation and infiltration/extravasation) and greater difficulty in performing blood sampling (therefore, in this case, it is advisable to have another sample collection site, such as a peripheral arterial catheter, based upon level of illness).

A particular problem related to the use of peripheral venous access devices (short cannulas, mini-Midline and Midline catheters) is their compatibility with the use of helmets for CPAP or noninvasive ventilation (NIV), often used in COVID-19 patients. 

Recently, several studies have highlighted the potential benefits of using peripherally inserted central catheters (PICC), if power injectable and in polyurethane (non-valved, open-ended) in intensive care unit. In the acutely ill patient with COVID-19, the use of these devices, especially if double-lumen (5Fr) and triple lumen (5Fr or 6Fr) is highly suitable, based on the following considerations:

  • the insertion of a PICC is completely free of risk of pleuropulmonary complications (pneumothorax, hemothorax), which can be fatal in patients with COVID-19 pneumonia;
  • the insertion of a PICC does not require that the patient is in supine position, but can also be performed in patients in a sitting position, and in extreme cases even in pronated patients;
  • the insertion of a PICC is theoretically safer for the operator than the insertion of a CICC, where the operator dangerously close to the patient's face and to his oral, nasal and tracheal secretions;
  • in patients on non-invasive ventilation (with mask or helmet), keeping the neck free from CICC is undoubtedly an advantage in terms of managing respiratory therapy and venous access;
  • in the pronated COVID-19 patient, the dressing of a CICC is inevitably more uncomfortable to manage (think of the difficulty in periodic monitoring of the exit site and in the connection/disconnection of the infusion lines) and it may be flooded by the patient's oral and tracheal secretions during the whole period of pronation, which can be very long (at least 12-16 hours/day);
  • several protocols recommend anticoagulation in COVID-19 patients - due to the high thrombotic risk and this is also a factor that makes the insertion of a PICC more desirable than a CICC;
  • the most severe COVID-19 patients have an average stay of almost 3 weeks and also for this reason PICCs offer considerable advantages, given the longer life expectancy of such devices;
  • a pre-existing Midline catheter can be used for the insertion of a PICC by simple replacement over guidewire (if no infection is suspected and no signs of thrombosis are visible at ultrasound);
  • the insertion of a PICC leaves the venous vessels in the supraclavicular and inguinal area free for ECMO cannulation

Recent studies have also demonstrated the reliability of PICCs in ICUs both for the detection of central venous pressure and for the measurement of cardiac output by thermodilution; in particular, with regard to the latter method, the results obtained using the main lumen of a triple lumen 6Fr PICC are not significantly different from those obtained by infusion in the distal lumen of triple lumen 7Fr CICC. Power injectable, multiple lumen PICCs have the same performance as a multiple lumen CICC in terms of comfort and infusion flow rate. The main limitation for PICC insertion is the availability of a vein of proper inner diameter (at least 5 mm vein for a 5Fr PICC; at least 6 mm for a 6Fr PICC), so to decrease the thrombotic risk.

In the absence of medical and nursing staff appropriately trained to PICC insertion, this option cannot be considered; however, it is not impossible to plan a rapid training course for professionals already skilled in ultrasound-guided venipuncture, so to make them able to insert also Midline and PICCs.

As an alternative to PICCs, in case of specific contraindications, or in the absence of specifically trained personnel, central insertion catheters (CICCs) will be used, obviously using ultrasound guidance. In the presence of helmets, face masks, tracheostomies, etc., an infra-clavicular approach (ultrasound-guided puncture and cannulation of the axillary vein) rather than a supraclavicular approach is recommended, in order to provide greater protection and stability of the catheter at the exit site. 

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Sai Kiran
Sales Manager at DataM Intelligence
Email: [email protected]
Tel: +1 877 441 4866

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