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In patients who require short-term vascular access, the optimal device remains unclear. Midline catheters (which extend to the axillary vein, distal to the shoulder) and peripherally inserted central catheters (PICCs; which extend near the right atrium) are ordered commonly for patients with challenging peripheral venous access or who require intravenous antibiotics, perhaps without much thought about potential risks.
Researchers in Michigan analyzed data from 48 hospitals on patients who received PICCs (5758 patients) or midline catheters (5105 patients) for 30 days or less. After adjusting for confounders, including catheter dwell time, PICCs were associated with twofold more major complications than were midline catheters, primarily cause…