Midline Catheters: Enticing Alternative to Central Lines in Critically Ill Patients

Fewer central lines are being placed in emergency departments, given evidence that peripheral administration of vasoactive agents can be safe and increased use of ultrasound guidance in patients with difficult access. Yet peripheral intravenous (IV)-line failure is common. One option is the midline catheter, a long (10–25 cm) catheter that is inserted into a peripheral vein and extends just proximal to the axilla but does not enter the central circulation. Midline catheters are placed using the Seldinger technique, generally with ultrasound guidance, and sterile technique.

These authors prospectively collected data on placement of 403 midline catheters in critically ill patients at a tertiary care center. Catheters were most commonly placed …