![]() ![]() Īs midline catheters are not considered CVCs, their infection rates are not routinely reported as part of CLABSI metrics. They represent an attractive option for short- to medium-term venous access in the inpatient and outpatient settings and are preferred for this indication by the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC). Midline catheters have a shorter indwell time (up to 4 weeks) compared with PICC lines (weeks to months) but are considerably more durable than peripheral IVs. ![]() These devices provide the benefit of durable access, but with shorter length and lower surface area, reducing the theoretical risk of thrombosis and contamination, as well as possibly lowering rates of infection. It is a shorter catheter inserted into the arm, like a PICC, but terminating at the basilic or axillary vein rather than the central venous circulation. The midline catheter has emerged as an alternative to PICC lines. The increasing use of PICCs has made the drawbacks of these devices obvious long-term lines are associated with thrombotic events and risk of luminal occlusion and pose risk of infection similar to other CVCs. The convenience of these devices, however, has led to misuse and overuse, including the utilization of PICC lines in patients with reliable peripheral access and no need for centrally administered medications. A systematic review by Chopra and colleagues in 2013 demonstrated a lower risk of central line–associated bloodstream infection (CLABSI) with PICC lines when compared with central venous catheters (CVCs). These lines are associated with low insertion risk and low rates of complications and allow for durable outpatient intravenous (IV) access, thereby facilitating timely dismissal of patients requiring prolonged IV infusions and frequent blood draws. Peripherally inserted central catheters (PICCs) have become ubiquitous in the care of hospitalized patients. Institutions should continue to review the utilization and safety data of IV catheter use to determine the most appropriate use of these devices.PICC, catheter, infection, midline, thrombosis The decision to move toward more use of MCs is not without risk. Patients with MCs were more likely to have complications than those with PICCs (19.5% vs 5.8%, P < .0001).ĬONCLUSIONS: MCs were associated with a higher risk of non-life-threatening complications versus PICCs, which showed fewer but more serious complications, including bacteremia. RESULTS: A total of 206 PICCs and 200 MCs were inserted in 367 patients within the study duration. Statistical software was used for analysis. ![]() Data were collected using electronic medical records and IV team insertion data. METHODS: This was a retrospective study comparing the use and outcomes of PICCs and MCs at a large academic medical center between January and May 2015. The objective of this study is to compare the utilization and safety of PICCs and MCs. Midline catheters (MCs) are peripheral IV access devices that may reduce the need for central lines and hence decrease central line-associated bloodstream infections. 2016 Dec 01 44(12):1458-1461Īuthors: Xu T, Kingsley L, DiNucci S, Messer G, Jeong JH, Morgan B, Shutt K, Yassin MHīACKGROUND: Peripherally inserted central catheters (PICCs) are a commonly used central intravenous (IV) access device, which can be associated with significant complications. Safety and utilization of peripherally inserted central catheters versus midline catheters at a large academic medical center.Īm J Infect Control. ![]()
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