Midline catheters represent a powerful and often underutilized choice in intravenous (IV) therapy, especially for patients requiring intermediate-term vascular access. Their unique position between short peripheral IV catheters (PIVCs) and central venous catheters (CVCs) offers a compelling blend of safety, efficiency, and patient centered benefits.
Extended Dwell Time
- Midlines can remain in place significantly longer than standard PIVCs, typically up to 28 days or more if no complications arise.
- This reduces the need for repeated venipunctures, minimizing patient discomfort and improving overall quality of care.
Lower Risk of Complications
- Compared to both PIVCs and central lines, midlines are associated with a lower risk of major complications, including phlebitis, infiltration, and central line associated bloodstream infections.
- Their peripheral placement means a reduced risk of bloodstream infections, making them a safer choice for many patients.
Ease of Insertion and Use
- Midlines can often be placed by trained nurses at the bedside, using ultrasound guidance for optimal vein selection.
- Insertion is less invasive than central line placement, does not require maximum sterile barrier precautions, and does not necessitate catheter tip verification.
Cost-Effectiveness
- The extended dwell time and lower complication rates translate to fewer device replacements, reduced need for additional supplies, and shorter hospital stays, all contributing to significant cost savings for healthcare facilities.
Improved Patient Comfort and Satisfaction
- Fewer needle sticks and less frequent catheter changes enhance patient comfort and satisfaction.
- Midlines allow for greater mobility and independence compared to central lines, supporting faster recovery and better quality of life.
Versatility for a Range of Therapies
- Midlines are suitable for a wide range of IV therapies, including hydration, antibiotics, and pain management, provided the infusates are non-vesicant, non-irritant.
- They are especially valuable for patients with difficult venous access or those requiring mid-term therapy.
Midlines are ideal for patients who:
- Need IV therapy for four weeks.
- Require medications that are safe for peripheral administration.
- Have difficult peripheral access or would benefit from fewer venipunctures.
- Are not candidates for central lines due to infection risk or other contraindications.
Limitations of Midlines:
- Not suitable for vesicant medications, parenteral nutrition, or infusates with high osmolarity (>900 mOsm/L).
- Not appropriate for therapies requiring central venous access or for long-term use beyond four weeks.
Midline catheters bridge the gap between short peripheral IVs and central lines, offering a powerful, safe, and cost-effective option for intermediate duration IV therapy. Their extended dwell time, lower complication rates, ease of insertion, and patient centered benefits make them an essential tool in modern vascular access management. With appropriate patient selection and staff training, midlines can significantly improve outcomes and patient satisfaction in IV therapy.
Explore our range of 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 standout as the best option. Please contact us today for more information about our products and for a custom quotation.
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/
Medbridge, (2024, September 10) Midline vs PICC: Which Is Best for Your Patient? https://www.medbridge.com/blog/midline-vs-picc-which-is-best-for-your-patient
Korycka, E. The Midline IV Catheter: An Alternative for Short-Term Infusions. Access Vascular. https://www.accessvascularinc.com/take-action/vascular-access-midline-alternative-to-short-term-infusions-extended-dwell-time
Moureau, N. Device Selection: When to Choose a Midline versus a PICC. Access Vascular. https://www.accessvascularinc.com/take-action/when-to-choose-piccs-vs-midlines-nancy-moureau
Villalba-Nicolau. Et al., (2022, October 31) Usefulness of Midline Catheters versus Peripheral Venous Catheters in an Inpatient Unit: A Pilot Randomized Clinical Trial. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9680301/
Rosenthal, K. (2007, May/June) Bridging the I.V. access gap with midline catheters. I.V. essentials. https://www.rch.org.au/uploadedFiles/Main/Content/anaes/bridging_the_IV_access_gap_with_midline_catheters.pdf