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 Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
Bard Access Systems