Mini midlines are a type of peripheral intravenous catheter that bridges the gap between short peripheral IVs and longer central lines like PICCs. These catheters are typically 8-10 cm in length and are inserted into veins in the forearm or upper arm, with the tip positioned no further than the axillary region.
Mini midlines are designed for medium-term therapy, usually lasting 1-4 weeks. They are particularly useful for patients with difficult IV access or those requiring frequent venipuncture. These catheters are suitable for administering non-vesicant medications and fluids, making them ideal for home infusion therapy.
The advantages of mini midlines include:
- Longer dwell time compared to short peripheral IVs
- Lower risk of complications such as phlebitis and infiltration
- Ease of insertion by trained nurses at the bedside
- Cost-effectiveness due to reduced need for multiple IV replacements
- Improved patient comfort with fewer needle sticks
However, mini midlines have limitations. They are not suitable for long-term treatments beyond 4 weeks, cannot be used for vesicant medications or those requiring central venous access, and are not appropriate for large volume fluid administration or high-pressure infusions.
When comparing mini midlines to PICC lines, the former offers several advantages in certain clinical situations. Mini midlines are associated with a lower risk of serious complications, including reduced bloodstream infections and fewer occlusions. They can be easier to place, requiring no X-ray confirmation, and generally can be comfortable for patients due to their less invasive nature.
The choice between a mini midline and a PICC line should be based on the patient’s specific needs, treatment duration, and type of medication to be administered. By understanding the appropriate use cases and advantages of mini midlines, healthcare providers can make informed decisions about vascular access options for their patients, balancing factors such as treatment duration, medication compatibility, and patient comfort.
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References:
Nickel, B. et al., (2024, January/ February) Infusion Therapy Standards of Practice 9th edition. Journal of Infusion Nursing. https://www.ins1.org/publications/infusion-therapy-standards-of-practice/
Salempoor H. et al., (2023, March 29). The U.S. Market For Extended Dwell Catheters. Med Device Online. https://www.meddeviceonline.com/doc/the-u-s-market-for-extended-dwell-catheters-0001
Urtecho, M. et al., (2023, January 18) Comparing Complication Rates of Midline Catheter vs Peripherally Inserted Central Catheter. A Systematic Review and Meta-analysis. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9898877/
Irisneida, M. et al., (2018, March 20) Mini-Midline a New device for Peripheral Venous Catheterization UN Emergency Wards. Juniper Publishers. https://juniperpublishers.com/jaicm/pdf/JAICM.MS.ID.555678.pdf