Midline vs. PICC: Which Is Better?

In a recent large observational comparison of peripherally inserted central catheters (PICCs) and midline catheters, PICCs were associated with twofold higher risk for major complications, primarily catheter occlusion and bloodstream infections. However, the study design precluded definitive conclusions about longer-term catheter performance (NEJM JW Gen Med Feb 1 2022 and JAMA Intern Med 2022; 182:50).

Researchers in a tertiary hospital in Canada performed a randomized, open-label, noninferiority trial to assess PICCs and midline catheters in 272 noncritically ill hospitalized adults. Catheter-related adverse events or dysfunction occurred in 33% of patients in the midline group and 7% of patients in the PICC group. The difference in this p…