Safety of Midline and Peripherally Inserted Central Catheters in a Pediatric ICU

This study examined the use of midline catheters in a pediatric intensive care unit (PICU) and compared their performance to peripherally inserted central catheters (PICC). 

This study entailed reviewing the hospital records of pediatric patients admitted to the PICU over 18 months – from July 2019 to January 2021. The data included patient details, indications for catheter placement, type of catheter, insertion attempts, infusions administered, dwell time, and complications. Overall, 161 midline catheters and 104 PICCs were used.

It was noted that midline catheters had a first-attempt success rate of 87.6%, while PICCs had a rate of 78.8%. The median age of the children was 7 years, with most being males. The common complications associated with midline catheters were pain (5.6%), blockage (5%), and thrombophlebitis (3.7%). The median dwell time for midline catheters was 7 days, while PICCs had a longer duration of backflow and dwell time.

The findings suggested that midline catheters are valuable in the PICU, particularly for moderately ill children––offering secure intravenous access lasting up to a week. These catheters were functionally similar to PICCs but had fewer complications. 

The study recommended early consideration of midline catheters for select patients in the PICU. Nevertheless, more research is needed to define the specific indications for midline catheters in this setting, given the limited availability of evidence-based guidelines for pediatric venous access devices.

Source: Raghunathan V, Dhaliwal MA, Singh DP, Singh GA, Singhi S.Indian Pediatrics. 2023 May 19:S097475591600536-.