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 based on several factors, including the patient's condition, the purpose of the catheter, and the presence of any complications.
- The median dwell time for midline catheters was reported to be 11 days (interquartile range, 5.5-19.5 days) in one study 2.
- Another study found a median indwelling time of 16.7 days (range, 0-76 days) 3.
- A systematic review reported an average dwell time of 16.3 days (n = 4,412) 4.
Factors Affecting Catheter Duration
Several factors can influence the duration of a midline catheter, including:
- Patient characteristics, such as body mass index and sex 3
- Catheter-related complications, such as occlusion, dislodgement, and infection 2, 3, 4
- The purpose of the catheter, such as antibiotic infusion or difficult access 2, 5
Comparison with Other Catheters
Midline catheters have been compared to other types of catheters, such as peripherally inserted central catheters (PICCs) and central venous catheters (CVCs).