QAPI 160 - The Use of Midline Catheters in Place of Central Venous Catheters for Vasopressor Administration to Reduce Central Line-associated Bacteremia

Background: Midline catheters have a lower incidence of bloodstream infections (BSI) compared with central venous catheters (CVC), with a reported BSI rate of between 0% and 0.9%. Exclusions for the use of midline catheters have traditionally included the use of vasopressors out of concern for the potential for local tissue injury due to the vasoconstrictive effects of these medications. Recent guidelines have allowed for the use of peripheral intravenous catheters for levophed and phenylephrine, and studies have supported midline catheter use as a safe alternative.

Methods: A twenty (20) bed medical intensive care unit and a fourteen (14) bed neuroscience intensive care unit in an acute care teaching hospital located in New York City trialed the use of midline catheters in patients requiring vasopressors between 7/5/23 - 12/1/23. A total of forty-two (42) patients had midline catheters inserted for the purpose of vasopressor administration.

Results: There were no complications of extravasation, infiltration or patient injury with patients with midlines in place who were receiving vasopressors. There were no central line associated bacteremias for patients whose only indication for a central line was for vasopressor administration.

Conclusions: The use of midline catheters is a safe and effective method for vasopressor administration and may reduce central line associated bloodstream infections.