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Comparison of complications in midlines versus central venous catheters: Are midlines safer than central venous

Ammara Mushtaq1, Bhagyashri Navalkele1, Maninder Kaur2

  • 1Department of Medicine, Detroit Medical Center/Wayne State University, Detroit, MI.

American Journal of Infection Control
|March 12, 2018
PubMed
Abstract

Insights

Midline catheters (MCs) demonstrate improved safety over central venous catheters (CVCs), with significantly fewer bloodstream infections. Further research is recommended to confirm these findings on catheter safety.

Area of Science:

  • Medical Devices
  • Infectious Diseases
  • Vascular Access

Background:

  • Rising utilization of midline catheters (MCs) necessitates safety validation.
  • Central venous catheters (CVCs) are associated with various complications.
  • Comparative safety data between MCs and CVCs is crucial for clinical decision-making.

Purpose of the Study:

  • To evaluate and compare the incidence of bloodstream infections (BSIs) and other complications between MCs and CVCs.
  • To assess the safety profile of MCs in relation to CVCs.
  • To provide evidence for optimal vascular access device selection.

Main Methods:

  • Retrospective cohort study conducted at a tertiary care hospital.
  • Inclusion of adult patients with either MC or CVC from March to September 2016.
  • Assessment of outcomes including catheter-related BSI (CRBSI), mechanical complications, length of stay, readmission, and mortality.

Main Results:

  • MC use was associated with a significantly lower rate of CRBSI (0.2% vs 3.5% for CVCs; P=.0008).
  • CVCs showed higher rates of mortality (17.3% vs 5.3%), readmission (58% vs 35%), and ICU transfer.
  • Mechanical complications were more frequent with MCs (2.6% vs 0.3% for CVCs; P=.03).

Conclusions:

  • Midline catheters appear to be a safer alternative to central venous catheters regarding bloodstream infections.
  • Central venous catheters are associated with a higher composite risk of adverse outcomes.
  • Larger-scale studies are warranted to definitively confirm the safety and efficacy of midline catheters.
Keywords:
Bloodstream infectionCentral venous catheterMidline catheterPeripherally inserted central catheters

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