SHM Converge Scientific Abstract ePoster Gallery-Characteristics and Outcomes of Midlines That Dwell Beyond 14 Days

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This study examined whether midline catheters that remain in place beyond 14 days have different outcomes than those removed within 14 days. Researchers analyzed 27,300 midline placements from 67 Michigan hospitals between 2016 and 2023 in hospitalized adults on general medicine or ICU services. Most midlines (88%) were removed within 14 days, while 12% stayed longer, with a median dwell time of 20 days.<br /><br />The main outcomes were major complications, minor complications, and device failure. Major complications included catheter-related bloodstream infection and catheter-related venous thromboembolism; minor complications included dislodgement, occlusion, tip migration, infiltration, superficial thrombosis, and exit-site problems.<br /><br />Overall complication rates were similar for the two groups when major and minor complications were combined. However, midlines dwelling longer than 14 days had higher rates of major complications: 2.7% versus 1.4%. They also had higher rates of catheter-related bloodstream infection (0.6% vs 0.2%) and catheter-related venous thromboembolism (2.1% vs 1.2%). In contrast, longer-dwell midlines had lower rates of minor complications overall (11.6% vs 13.1%) and lower device failure (9.4% vs 12.5%), with less dislodgement and tip migration.<br /><br />The most common indication for midline placement was antibiotic infusion.<br /><br />The authors concluded that midlines are often used for more than 14 days and can remain in place longer than guidelines traditionally recommend. While longer dwell time was linked to more serious complications, it was associated with fewer minor problems and less premature device removal. They suggest future research should consider the role of specific infusates in these outcomes.

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David Paje

Meta Tag

Author List Anurag N. Malani, David Paje, Elizabeth McLaughlin, Emily A. Walzl, Jennifer K. Horowitz, Megan Heath, Scott A. Flanders, Steven J. Bernstein, Vineet Chopra

Category Research

Concept Midline Catheter

Concept Dwell Time

Concept Complication

Concept Catheter Failure

Concept Catheter-Related Bloodstream Infection

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Patient Safety

Keywords

midline catheters

dwell time

14 days

complications

catheter-related bloodstream infection

venous thromboembolism

device failure

hospitalized adults

antibiotic infusion

Michigan hospitals

Midline Catheter

Dwell Time

Complication

Catheter Failure

Catheter-Related Bloodstream Infection