Objective: Midline catheters are recommended over peripherally inserted central catheters as short-term vascular access device for peripherally compatible infusates. We assessed the effectiveness and safety of midline catheters.
Methods: Data from midline catheter placements from 06/2016-05/2019 at a tertiary-care Veterans Administration medical center were retrospectively collected. Patients were followed until catheter removal or death, whichever occurred first. The primary outcome was completion of intended therapy; secondary outcomes were catheter-related complications, including major (e.g., catheter-related bloodstream infections or venous thromboembolism ) and minor (e.g., catheter occlusion, kinking, dislodgement) events.
Results: Of 115 midlines, 62 (53.9%) were for antibiotic infusion and 49 (32.6%) for difficult access. The median dwell time was 11 days (interquartile range, 5.5 to 19.5 days). Midline catheters lasted through completion of therapy in 93 patients (80.9%). Catheter-related complications occurred in 27 patients (23.5%), including catheter dislodgement in 10 patients (8.7%), catheter kinking in 8 (7.0%), and catheter occlusion in 3 (2.6%). Only 1 patient experienced a major complication, a deep venous thrombosis (0.9%).
Conclusions: Midlines appear to be effective and safe for short-term vascular access in patients requiring peripherally compatible infusates. While the rate of major complications is low, minor complications that necessitate device removal are common.Reference:
Johnson A, Gupta A, Feierabend T, Lopus T, Schildhouse R, Paje D. Midline Catheters: A 3-Year Experience at a Veterans Administration Medical Center. Am J Infect Control. 2022 Aug 7:S0196-6553(22)00600-9. doi: 10.1016/j.ajic.2022.08.002. Epub ahead of print. PMID: 35948122.