Highlights
- •A comparative study PICC and midline catheters.
- •Midlines are increasingly used in place of PICC lines at many institutions.
- •Increased use of midline catheters does not decrease risk of complications.
Abstract
Introduction
To decrease the complications related to central catheters there has been an increasing
utilization of peripherally inserted central catheters (PICC) and ultrasound-guided
long peripheral intravenous catheters (i.e. midlines). While the complications of
PICC lines are well described there is less reported data on complications related
to midline catheters. Our study aims are to compare the incidences of infectious and
deep venous thrombosis (DVT) and sepsis related to PICCs and Midlines.
Methods
We performed a single-center retrospective review at an academic hospital. Data were
collected on patients admitted between 1/1/2014–5/31/2016. Patient demographics, hospital
length of stay (LOS), and ventilator days were collected. Outcomes of interest were
line-related infections and thromboembolic events after the placement of these catheters.
Endpoints were compared between three groups (PICC group, midline group and PICC placement
followed by midline placement group). Univariate and multivariable analyses were used
to compare across the three groups.
Results
The study included 3560 unique patients with 5058 catheters. There was an increase
in use of midlines over the observed study period (245% increase from the end of 2015
to the middle of 2016). We found no significant differences in the rates of DVT among
the three groups (PICC 4%, midline 3% and PICC-midline 4%; p = 0.12). There were no
differences across the groups for sepsis (PICC 29%, midline 27%, and PICC-midline
32%; p = 0.14) or septic shock (PICC 7%, midline 8%, and PICC-midline 6%; p = 0.39).
Adjusted means LOS were higher for patients with PICC lines compared to midlines,
in both females and males. PICC group stayed longer, on average, on the ventilator
compared to the midline group. No other significant differences were seen among groups.
Conclusion
Increased utilization of midline catheters were not associated with decreased risk
of DVT or sepsis when compared to peripherally inserted central catheters.
Keywords
Abbreviations:
PICC (peripherally inserted central catheter)To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: September 25, 2021
Accepted:
September 24,
2021
Received in revised form:
September 22,
2021
Received:
July 3,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
