Midline catheters for patients with difficult vascular access
Abstract:
Background: Intravenous infusion is a key aspect of therapy in hospitalised patients. Choosing the right vascular catheter is important to minimise damage to the patient’s tissues, improve the quality of medical care and reduce costs associated with treatment complications. The purpose of this study was to review the effectiveness of midline catheters as a strategic component of intravenous infusions in a Polish hospital.
Material and methods: The study material consists of medical records of patients with midline catheters at Czerniakowski Hospital in Warsaw over the period from 5th October 2021 to 19th May 2023. An analysis of 341 infusion observation charts was performed, excluding illegible and incomplete data. In this article, all of the catheters we used were inserted under ultrasound guidance.
Results: The type of vein chosen has no significant effect on the catheter dwell time (p = 0.984). Catheter length correlates with catheter dwell time (r = 0.133; p = 0.016). Catheters with a length of 15 cm have the longest dwell time, while those with a length of 20 cm have the shortest. Completion of therapy or patient death was the most common reason for catheter removal (46.9%). Catheter size had an impact on catheter dwell time (p = 0.034). The text presents observations regarding the relationship between catheter diameter and total aspiration time, based on all days during which blood was aspirated through the catheter. The statistical test results (H = 118.268; p < 0.001) indicate a significant impact of catheter diameter size on total aspiration time.
Conclusions: Midline catheters are an effective solution for patients with difficult vascular access, increase the possibility of intravenous therapy. Moreover, they improve patient comfort and reduce the number of multiple cannulations. Developing vascular access teams can better control infusion management and care.
Reference:
Cichowlas G, Fornal I, Latos M, Kosson D. Midline catheter insertion as a strategic component of intravenous infusion: A single-centre retrospective analysis. J Vasc Access. 2025 Feb 12:11297298251316956. doi: 10.1177/11297298251316956. Epub ahead of print. PMID: 39935393.