Midline Venous Catheter vs Peripherally Inserted Central Catheter for Intravenous Therapy: A Randomized Clinical...

Area of Science:

• Vascular Access Devices
• Clinical Trials
• Medical Interventions

Background:

• Peripherally inserted central catheters (PICCs) are commonly used for intravenous therapy (IVT).
• Peripheral midline venous catheters (MVCs) offer an alternative for IVT and blood draws, potentially avoiding central venous access.
• Assessing the noninferiority of MVCs compared to PICCs is crucial for patient care.

Purpose of the Study:

• To evaluate if midline venous catheters (MVCs) are noninferior to peripherally inserted central catheters (PICCs).
• To compare the incidence of vascular access-related adverse events and dysfunctions between MVCs and PICCs.

Main Methods:

• A randomized clinical trial involving adult patients referred for PICC insertion.
• Participants were randomized to receive either an MVC or a PICC.
• The primary outcome was the percentage of patients without vascular access-related adverse events or dysfunctions.

Main Results:

• A total of 294 patients were randomized; 135 in the MVC group and 137 in the PICC group were analyzed.
• 66.7% of patients in the MVC group and 93.4% in the PICC group were free from vascular access complications.
• The noninferiority of MVCs compared to PICCs could not be demonstrated.

Conclusions:

• Midline venous catheters (MVCs) are associated with a higher percentage of vascular access-related complications.
• MVCs cannot be considered a noninferior alternative to PICCs for intravenous therapy.
• PICCs remain a more reliable vascular access option based on this trial's findings.