How long does a midline catheter last?

From the Guidelines

The duration of midline catheter placement typically ranges from 1 to 4 weeks, with an average dwell time of 14 to 21 days 1.

Key Points

• Midline catheters are often used for intermediate-term intravenous therapy, such as administering antibiotics like ceftriaxone or vancomycin, and may be replaced or removed once the treatment course is completed, usually after 2 to 4 weeks of continuous use.
• In general, midline catheters are not intended for long-term use, and their duration is limited by the risk of complications, including catheter-related bloodstream infections and thrombophlebitis.
• According to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC), midline catheters are rated as appropriate for 14 or fewer days of use 1.
• The ESPEN guidelines on parenteral nutrition recommend considering midline catheters as a potential option when peripheral therapy is expected for more than 6 days, and stress the importance of careful surveillance for thrombophlebitis 1.

Important Considerations

• The risk of complications, such as catheter-related bloodstream infections and thrombophlebitis, increases with the duration of midline catheter placement.
• Midline catheters should be used for intermediate-term intravenous therapy, and their duration should be limited to 1 to 4 weeks.
• The decision to use a midline catheter should be based on the individual patient's needs and the expected duration of therapy.

From the Research

Midline Catheter Duration

The duration of a midline catheter can vary depending on several factors, including the patient's condition, the type of infusion, and the catheter's maintenance.

• The median dwell time for midline catheters was 11 days (interquartile range, 5.5-19.5 days) in a study published in the American Journal of Infection Control 2.
• A prospective observational pilot study published in Anesthesia and Analgesia found that the median catheter dwell time for pediatric midline catheters was 6 days (range, 4-8 days) 3.
• Another study published in the Journal of Critical Care reported an average midline dwell time of 14.7 ± 12.8 days for patients receiving vasopressors via midline catheters 4.
• A pilot randomized clinical trial published in Nursing Reports found that midline catheters had a longer duration of cannulation (8.13 days) compared to peripheral intravenous catheters (3.22 days) 5.

Factors Affecting Midline Catheter Duration

Several factors can affect the duration of a midline catheter, including:

• Patient characteristics, such as age and comorbidities 6
• Type of infusion, such as antibiotics or vasopressors 2, 4
• Catheter maintenance and care 2, 5
• Insertion site, with arm vein insertion potentially having a lower risk of complications compared to saphenous vein insertion 3

Complications and Midline Catheter Duration

Complications can also impact the duration of a midline catheter.

• A study published in the American Journal of Infection Control found that catheter-related complications occurred in 23.5% of patients, including catheter dislodgement, kinking, and occlusion 2.
• Another study published in Anesthesia and Analgesia reported that catheter-related venous thromboembolism (VTE) occurred in 30% of pediatric midline catheters 3.
• A study published in the Journal of Critical Care found that the early complication rate for midline catheters was 3.6%, with late complications occurring in 0.8% of patients 4.