Midline catheters versus peripherally inserted central catheters (PICC) in children: A randomized clinical trial

Abstract

Purpose-Objective. To determine the feasibility and safety of midline versus peripherally inserted central catheter (PICC) in pediatric patients. Material and methods. 153 consecutive children referred to the Department of Radiology for intravenous catheter insertion were prospectively randomized in 2 groups: midline catheter (extremity at the proximal subclavian vein) or PICC lines. All patients were less than 18 years and weighed more than 3 kg. The primary outcome was the dwell-time of the catheter; secondary outcomes were catheter complications (deep vein thrombosis or infection). Results. Study population: 84 PICC lines and 69 midlines. PICC lines dwell-time was 1-105 days (mean: 20.1, median: 14.5), and midline dwell-time was 3-77 days (mean: 17.9, median: 12.0). Catheter dysfunction was noted in only 1 case (PICC line). No statistically significant difference was observed between the type of catheter and their dwell-time (p=0.214). However, a statistically significant difference between the type of catheter and the incidence of deep vein thrombosis was noticed (p<0.02) (midline: n=5, PICC line: n=0). No catheter-related infection was seen in either groups. Discussion and conclusions. There is no significant difference between midline and PICC line dwell-time. However, midline catheter safety is yet to be determined since our study results demonstrate a higher incidence of deep vein thrombosis in this group.