From the Guidelines
The primary distinction between an AccuCath IV and a profiled midline IV lies in their intended duration of use, with AccuCath IVs suited for short-term use (up to 7 days) and profiled midline IVs designed for intermediate-term therapy (up to 29 days). When deciding between these two options, it's crucial to consider the expected duration of infusion, as well as the type of medication being administered. According to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) 1, midline catheters may be used for up to 4 weeks and are approved for such duration of use. Key differences between the two include:
- Intended duration of use: AccuCath IVs for short-term (up to 7 days) versus profiled midline IVs for intermediate-term (up to 29 days)
- Placement depth: AccuCath IVs are inserted into peripheral veins with the catheter tip remaining in the peripheral vasculature, while profiled midline IVs are advanced to terminate in the larger veins of the upper arm
- Medication compatibility: Profiled midlines can accommodate a wider range of medications, including some that may be irritating to smaller peripheral veins
- Insertion procedure: Profiled midline insertion is more complex, often requiring ultrasound guidance and specialized training, whereas AccuCath IVs can be placed by any trained nurse using standard techniques. Given these considerations, the choice between an AccuCath IV and a profiled midline IV should be based on the specific needs of the patient, including the expected duration of therapy and the characteristics of the medication being administered, as outlined in guidelines such as those provided by the MAGIC study 1.
From the Research
Types of IV Catheters
- Accucath IV: No specific information is available in the provided studies regarding Accucath IV.
- Profiled Midline IV: Midline catheters are long peripheral venous catheters, typically ranging from 10 to 25 cm in length, and are used as an alternative to central venous catheters and PICC-lines when peripheral venous access is impossible or when patients require prolonged intravenous treatment 2, 3.
Key Characteristics of Midline Catheters
- Can be inserted at the patient's bedside without radiological verification after insertion 2.
- Can be kept in place for up to 14 days and allow for repeated blood sampling 2, 4.
- Have a similar safety profile to other venous catheters, with no significant difference in mechanical, infectious, or thrombotic complications 2, 4, 5.
Comparison with PICC-lines
- Midline catheters are associated with a lower risk of bloodstream infection and occlusion compared to PICC-lines for short-term indications 5.
- The risk of deep vein thrombosis (DVT) may be similar or greater with midlines compared to PICCs for short-term use, but more research is needed to confirm this 5.
- Midline catheters may be a feasible alternative to central venous access in certain critically ill patients, with a high success rate and low complication rate 3.