Midline Catheter Use in the Intensive Care Nursery

Abstract

Purpose: To describe the use of midline catheters in a Level IV, 48-bed NICU over a four-and-a-half-year period.Design: Nonrandomized prospective review of data obtained for quality assurance monitoring.Sample: 1,130 catheters inserted in 858 patients ranging in age at insertion from 1 to 249 days, 360–8,000 gm in weight, and 23–42 weeks gestational age at birth.Outcome Variables: Catheter outcome data related to dwell times; patient characteristics; insertion site; and reason for removal, including failure related to infiltration, leaking, occlusion, dislodgment, infection, phlebitis, or malposition.Results: There was no significant statistical difference in median catheter survival times related to weight or postconceptional age. Overall mean catheter dwell time was 8.7 days. Scalp was the most common insertion site (49 percent), and the site with the longest dwell time was the saphenous vein at the knee, which lasted a mean of 12.9 days. Elective removal represented 43 percent of all removals. Incidence of positive blood culture was 3.5 percent (0.41/1,000 catheter days), with the risk significantly higher if a central line was also in place.