Midline catheters are long (8 to 20 cm) peripherally inserted lines that terminate in or just distal to the axillary vein. They’re shorter than peripherally inserted central catheters (PICCs), which usually terminate in the superior vena cava. Midlines have become widely adopted, but there's been very little quality data to guide their use.
Retrospective single center series have reported varied results, with some suggesting a lower rate of bacteremia (a.k.a. CRBSI) with midlines, while others suggest a much higher rate of complications overall with midlines, including CRBSI. A single center randomized trial in Denmark adds to the conversation.
Authors randomized 304 adults requiring IV access for 5 to 28 days, either as inpatients or outpatients, to receive a new generation midline or PICC.
After 90 days:
There were no CRBSIs in the midline group, and only one in the PICC group.
Patients in the midline group required early catheter removal more often (13% vs 7%).
There were no sympto…
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