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Mid-lines and DVT rates
Having a "healthy" discussion regarding the use of Mid-lines at our institution.  Wondering if anyone can direct me to published studies regarding Mid-lines and DVT incidence? Would also like to hear personal experience.
Here is what I have on

Here is what I have on midlines:

1.    Hadaway LC. A midline alternative to central and peripheral venous access. Caring. 1990;9(5):45-50.
2.    Hadaway LC, Lawson T. Infusion of IV medications via midline catheters in home care patients. Infusion Magazine. 1995;1(6):15-19.
3.    INS. Position paper: Midline and midclavicular catheters. Journal of Intravenous Nursing. 1997;20(4):175-179.
4.    Lawson T. Infusion of medications via PICC and midline catheters in patients with AIDS. Journal of Vascular Access Devices. 1997;2(4):7-10.
5.    Lawson T. Infusion of IV medications and fluids via PICC and midline catheters. Journal of Vascular Access Devices. 1998;3(2):11-17.
6.    Harwood I, Green L, Kozakowski-Koch J, Razor J. New peripherally inserted midline catheter: A better alternative for intravenous antibiotic therapy in patients with cystic fibrosis. Pediatric Pulmonology. 1992;12:233-239.
7.    Wood D, Bowe-Geddes L. A comparative retrospective analysis of two securement techniques for peripherally inserted central catheters (picc) and midlines in the homecare setting. Journal of Vascular Access Devices. 1997;2(3):11-17.
8.    Haworth C, Niven RM, Moorcroft A, Phillips A, Dodd M, Webb A. Acute anaphylaxis following midline cathertisation in a patient with cystic fibrosis. Thorax. 1998;54:747.
9.    Vanek V, Kupensky D, Thomson D. Hypersensaitivity-like reactions related to insertion of Aquavene-based midline and PICC catheters. Journal of Intravenous Nursing. 1997;20(1):23-27.
10.    Gorski L, Czaplewski L. Peripherally inserted central and midline catheters for the home care nurse. Home Healthcare Nurse. 2004;22(11):758-771.

These articles have not reported a specific DVT rate for midlines that I can recall. In my experience, DVT with midlines can be seen when they are chosen for the wrong patient or therapy.

They are only indicated when the therapy has osmolarity less than 600 and pH between 5 and 9 and when the therapy will be needed for 1 to 4 weeks. They are NOT a replacement for a CVC. They are a replacement for repeated peripheral sticks when the therapy meets this critieria.  


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

From my personal experience
From my personal experience have not really seen an increase in DVT's, however do not like simply because of the limitations. I believe Kathy has posted several opinions that I agree with from my experience. Find that they are difficult to draw from after a few days. Many times they leak from the insertion site, possibly due to sheath, etc. I agree that it beats a PIV but barely. More commonly than with a PICC find extremity swelling with no definitive explanation, i.e. doppler.
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems


Midline Catheters:

The Middle Ground of Intravenous Therapy Administration 


N. Richard Anderson RN CRNI

Published in JIN I believe in 2005 as I helped him write it

very strict limitations on their usage in the article and the hospital was not a teaching institution and had a very structured environment.  They were only 110 beds.

Day three midlines often  stop giving blood return and are dysfunctional so are they better than a PIV.  Not sure.


Kathy Kokotis

Bard Access Systems

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