In the medical field, various types of catheters exist. However, one common query revolves around the distinction between Midline Catheters and Peripherally Inserted Central Catheters (PICCs). In this article, we will define each and clarify their differences.
According to the Infusion Nurses Society, Midline Catheters and PICCs are defined as follows:
Midline Catheter: Inserted into a peripheral vein of the upper arm via the basilic, cephalic, or brachial vein, with the terminal tip located at the level of the axilla in children and adults. For neonates, in addition to arm veins, midline catheters may be inserted via a scalp vein with the distal tip located in the jugular vein above the clavicle or in the lower extremity with the distal tip located below the inguinal crease.
Peripherally Inserted Central Catheter (PICC): A catheter inserted through veins of the upper extremity or neck in adults and children. For infants, it may be inserted through veins of the scalp or lower extremity. The catheter tip is located in the superior or inferior vena cava, preferably at its junction with the right atrium, regardless of the insertion site.
Midline catheters and PICCs are both vascular access devices used for delivering medications, fluids, or drawing blood samples. However, they possess distinct differences that render each suitable for different cases.
Location: The catheter tip of a midline catheter is at or near the axilla level and distal to the shoulder, making it a peripheral line.
Dwell Time: Midline catheters can remain in place for up to 30 days.
Indications: Used for intravenous therapies, blood sampling, and various conditions like difficult peripheral venous access, frequent phlebotomy, and more.
Advantages: Reduce repeated venipunctures, can be used for 2-4 weeks, infusion of antibiotics, hydration, pain medication, and venous sampling.
Contraindications: Include history of venous thrombosis, restricted blood flow to extremities, infections related to the device, known allergies, among others.
Location: The catheter tip of a PICC line is located in the lower third of the superior vena cava.
Dwell Time: Used for long-term therapies lasting longer than 4 weeks.
Indications: Suitable for therapies requiring a central line like parental nutrition and chemotherapies.
Advantages: Administration of various fluids and medications in patients with unsuitable veins for repeated access, preserves peripheral veins, reduces risks like phlebitis and infiltration.
Contraindications: Risk of venous thrombosis with unstable hypercoagulable, infections related to the device, known allergies, preexisting skin infections, severe peripheral edema, among others.
In summary, while midline catheters are peripheral lines suitable for short-to-medium term use with specific indications and advantages, PICC lines are central lines designed for long-term therapies with different benefits and considerations. The decision between the two options relies on factors like the required duration of treatment, the patient’s medical status, and the accessibility of resources and expertise for inserting and managing the device.
Explore our range of PICC Lines and Midlines catheters, customized to meet your unique requirements with a variety of configurations. Designed to satisfy the needs of both medical professionals and patients, our vascular access devices stand out as the best option. Please contact us today for more information about our products and for a custom quotation.
References:
Gorski, L. et al. (2021, January) Infusion Therapy Standards of Practice. Journal of Infusion Nursing. https://journals.lww.com/journalofinfusionnursing/citation/2021/01001/infusion_therapy_standards_of_practice,_8th.1.aspx
Vascular Access Program (2016) PICCs and Midlines Catheters. University of Washington Medical Center. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://healthonline.washington.edu/sites/default/files/record_pdfs/PICCs-Midline-Catheters.pdf
Moureau, N. Device Selection: When to Choose a Midline versus a PICC. Access Vascular Inc. https://www.accessvascularinc.com/take-action/when-to-choose-piccs-vs-midlines-nancy-moureau
Moureau, N. et al. (2016) Guiding Vascular Access Selection for Intensive Care – a Summary of Michigan Appropriateness Guide for Intravenous Catheters (MAGIC). ICU Management & Practice 2. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.improvepicc.com/uploads/5/6/5/0/56503399/icu_v16_i1-nancymoureau_cpamend_v2.pdf