title: Safety and utilization of peripherally inserted central catheters versus midline catheters at a large academic medical center.
abstract: Peripherally inserted central catheters (PICCs) are a commonly used central intravenous (IV) access device, which can be associated with significant complications. Midline catheters (MCs) are peripheral IV access devices that may reduce the need for central lines and hence decrease central line-associated bloodstream infections. The objective of this study is to compare the utilization and safety of PICCs and MCs.
  
  
  
  This was a retrospective study comparing the use and outcomes of PICCs and MCs at a large academic medical center between January and May 2015. Data were collected using electronic medical records and IV team insertion data. Statistical software was used for analysis.
  
  
  
  A total of 206 PICCs and 200 MCs were inserted in 367 patients within the study duration. Patients with MCs were more likely to have complications than those with PICCs (19.5% vs 5.8%, P < .0001).
  
  
  
  MCs were associated with a higher risk of non-life-threatening complications versus PICCs, which showed fewer but more serious complications, including bacteremia. The decision to move toward more use of MCs is not without risk. Institutions should continue to review the utilization and safety data of IV catheter use to determine the most appropriate use of these devices.
authors.affiliation: Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Tianyuan
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Kingsley
authors.affiliation: Infection Control Department, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA.
authors.forename: Susan
authors.initials: S
authors.lastname: DiNucci
authors.affiliation: Infection Control Department, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA.
authors.forename: Gwen
authors.initials: G
authors.lastname: Messer
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; Department of Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Jong-Hyeon
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Intravenous Access Team, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA.
authors.forename: Brian
authors.initials: B
authors.lastname: Morgan
authors.affiliation: Infectious Diseases Division, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Shutt
authors.affiliation: Infection Control Department, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA; Infectious Diseases Division, University of Pittsburgh, Pittsburgh, PA. Electronic address: mhy8@pitt.edu.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Yassin
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
keywords: Central line–associated blood stream infection (CLABSI); Midline catheter (MC); Peripherally inserted central venous catheter (PICC)