Abstract
Background:
Deep vein catheterization is common in patients with advanced cancer, but safety and cost comparisons between catheter types are limited.
Purpose:
To evaluate the safety and economic impact of a modified medium-length catheter versus a standard peripherally inserted central catheter (PICC) line in patients with advanced cancer.
Methods:
A prospective cohort study was conducted involving 160 patients with advanced cancer receiving palliative care between January 2022 and April 2024. Patients were randomized to a study group (modified medium-length catheter) or control group (PICC line). Venous complications, satisfaction, and costs were compared.
Results:
The study group had lower rates of venous thrombosis, bleeding, and catheter infection. Patient satisfaction and costs were also significantly better in the study group.
Conclusions:
The modified medium-length catheter provides better safety, higher satisfaction, and reduced costs, making it a preferred option for patients with advanced cancer.
Keywords: advanced tumor, clinical advantage, modified medium-length catheter, PICC, safety evaluation
INTRODUCTION
With the acceleration of population aging in China, the incidence of malignant tumors is increasing.1,2 Malignant tumors often present with subtle or late symptoms, making timely diagnosis challenging and underscoring the importance of palliative care.3 Patients undergoing palliative care frequently require long-term and continuous intravenous (IV) therapies, including chemotherapy, nutritional support, and pain management. This prolonged and complex need for IV administration presents significant clinical challenges and is associated with a higher risk of complications such as infection, pain, and electrolyte imbalances. Thus, effective treatment management must address not only the malignancy itself but also consider the patient’s overall condition and comfort during care.4
To receive IV therapies, patients with advanced cancer often require vascular access devices such as peripherally inserted central catheters (PICCs). However, PICCs are associated with risks including increased risks of phlebitis, catheter-related thrombosis, and catheter obstruction, which can contribute to patient discomfort and elevated treatment costs.5,6 As an alternative, midline catheters – sometimes referred to as medium-length catheters – have a shorter insertion length (typically 8-20 cm vs. 45-65 cm for PICCs) and may reduce the rate of complications. The midline catheter is inserted through a peripheral vein and extends from its tip to the thoracic segment of the axillary or subclavian vein, facilitating infusion. Midline catheters have attracted growing clinical interest due to their intermediate dwell time, simplified placement technique, and potentially lower complication rates.7-9 Midline catheters are categorized as Class II devices by the U.S. Food and Drug Administration (FDA) and are widely approved for use in clinical practice in the U.S. Representative FDA-approved products include PowerGlide™ and Bard™ midline catheters. Compared to PICCs, midline catheters are associated with fewer central line-associated complications and are increasingly being considered for patients requiring intermediate to long-term IV therapy. One research study found the average indwelling time for midline catheters is 6.1 days and can reach 17 days, demonstrating a longer potential for use under specific conditions.10 This duration supports long-term IV therapy and reduces the need for repeated punctures.
However, given the relatively recent clinical introduction in China, research on midline catheters in patients with advanced cancer remains limited. According to the American Association of Infusion Nurses’ Standards of Practice for Intravenous Infusion Therapy,11 there remains a risk of fluid leakage with standard midline catheters. This risk is particularly high for continuous infusion of corrosive drugs, fluids with pH < 5 or > 9, IV nutrition solutions, as well as liquids with osmolality > 600 mOsm/L.12 To mitigate these risks and expand the indications for drug use, we modified the catheterization technique by increasing the catheter length to reach the subclavian vein, but not extending beyond the brachial vein, distinguishing it from traditional PICC lines. This modified method has been clinically validated.13,14 It is crucial to explore the effectiveness, clinical advantages, and safety of modified midline catheters for IV therapy in this patient population.
This study aimed to compare the safety, cost, and patient satisfaction between PICC and modified midline catheters in patients with advanced cancer receiving palliative treatment. The goal of this study was to provide a safer, more effective, and economical solution for IV treatment, ultimately enhancing the treatment experience and comfort during care for individuals with advanced cancer.
METHODS
Design, setting, and sample
This study was designed as a single-center randomized controlled trial conducted at a Class A tertiary comprehensive teaching hospital in China with approximately 2100 inpatient beds. The study involved 160 patients with advanced cancer who received palliative treatment at our hospital from January 2022 to April 2024. The participants were randomly assigned into 2 groups, with 80 patients in each group. The control group included patients who underwent PICC insertion via peripheral veins under ultrasound guidance. The study group consisted of patients who received modified medium-length catheter insertion, also under ultrasound guidance. The 2 groups differed in terms of catheter type, insertion technique, maintenance frequency, and required equipment. A detailed description of the catheter placement and maintenance procedures is provided in Supplemental Digital Content, Appendix, available at: http://links.lww.com/JNCQ/B459. All enrolled patients were hospitalized during the catheterization period for IV nutritional support. However, long-term outcomes such as death or discharge destination were not tracked beyond the catheterization period.
Inclusion criteria included subjects with the following: (1) a definitive diagnosis of advanced malignant tumor; (2) receiving palliative care and required long-term IV administration; (3) ability to communicate effectively and provide reliable feedback; and (4) willingness to participate in this study. Exclusion criteria included subjects with the following: (1) contraindications to either medium-length catheter or PICC; (2) unable to complete follow-up after the insertion procedure; (3) significant comorbidities, including blood disorders, autoimmune diseases, or severe cardiopulmonary conditions; and (4) mental illness or cognitive dysfunction that could impair their ability to provide informed consent or participate effectively. The current study was approved by the Ethics Committee of our hospital. Written informed consent was obtained from all participants.
Observation index
Catheter-related complications were recorded prospectively during the entire catheterization period, from insertion to removal. Complications were documented by the nursing staff using a standardized complication report form, which included predefined categories such as catheter-related infections, accidental dislodgement, lumen blockage, wound bleeding, and venous thrombosis.15 Any complication was evaluated according to the institutional clinical criteria and verified by the attending physician. Patient satisfaction data were collected within 1 month after catheterization. A structured, author-developed patient satisfaction questionnaire was used to assess patient satisfaction with catheter-related nursing care. The questionnaire comprised 10 items covering insertion comfort, communication with health care staff, clarity of catheter-related health education, perceived cost burden, convenience of daily catheter use, maintenance costs, standardization of nursing procedures, service attitude of nursing staff, first-attempt insertion success rate, post-insertion guidance and follow-up, and overall satisfaction with catheter-related care. The item “standardization of nursing procedures” in the patient satisfaction questionnaire refers to patients’ subjective perception of whether nursing care – such as catheter maintenance, disinfection, dressing changes, and communication – was delivered in a consistent, professional, and orderly manner. Each item was scored from 0 to 10, with a total score ranging from 0 to 100; higher scores indicated higher patient satisfaction. To ensure content validity, the questionnaire was reviewed by a panel of 5 experts in palliative care and vascular access and modified accordingly. Internal consistency was assessed using Cronbach’s alpha in a pilot cohort of 20 patients (α = 0.82). In this study, “first-attempt insertion success rate” was included as 1 of the items in the patient satisfaction questionnaire. It was scored by patients based on their subjective perception of the catheter insertion experience, primarily reflecting their overall impression of the procedure.
The total catheter indwelling time was recorded for each patient, from insertion to removal. At the time of discharge, the expenses associated with the catheter were recorded, including the average catheter maintenance costs, the daily average catheter maintenance costs, and the total average costs for the catheter. The average catheter maintenance cost refers to the mean per-patient expenditure incurred during the catheter indwelling period, including the cost of consumables (eg, dressings, heparin flushes, disinfectants) and nursing care services related to catheter maintenance; this is expressed in CNY per person. The daily average catheter maintenance cost refers to the mean expenditure per patient per day for catheter-related materials and services. The total average cost for the catheter refers to the mean overall catheter-related expense per patient, including both catheter insertion materials and maintenance costs, expressed in units of CNY per person. All cost data were derived from the hospital’s electronic medical record system and billing database. For each patient, we conducted a retrospective chart review to document the actual number of dressing changes, catheter flushes, disinfection procedures, and nursing interventions performed during the catheter indwelling period. Unit costs for each consumable (eg, dressings, heparin flushes, disinfectants) and service were based on the standard price list maintained by the hospital’s finance department. The total cost per patient was calculated by multiplying the quantity used by the corresponding unit price.
Data analysis
Data processing and analysis were conducted using the SPSS Statistics, version 26.0 (IBM Corp., Armonk, NY, USA). Measurement data were represented as means and standard deviations when they were normally distributed and showed homogeneity of variance. Categorical data were expressed as counts and percentages [n (%)] and analyzed using the chi-square (χ2) test, while continuous variables were presented as mean and standard deviation and analyzed using the independent samples t-test. P-value less than .05 was the threshold for statistical significance.
RESULTS
There were 80 patients in the study group. Most (n = 43, 53.8%) were male, with a mean age of 62.38 years (SD = 6.21, range 39-69). Patients in the study group had been diagnosed with advanced cancer on average for 4.59 years (SD = 3.01) with a range from 2 to 6 years. The average catheter indwelling time in the study group was 15.41 (SD = 38.3) days. The average body mass index (BMI) was 20.12 (SD = 2.15) kg/m2. Among the patients, 7 had a history of cancer recurrence and 5 exhibited drug resistance. Most patients had lung cancer (n = 22) or gastric cancer (n = 20).
There were 80 patients in the control group. Most (n = 49, 61.3%) were male, with a mean age of 61.11 years (SD = 6.03, range 41-71). The average catheter indwelling time in the control group was 15.50 (SD = 4.05) days. The average BMI was 20.08 (SD = 2.11) kg/m2. Most patients had lung cancer (n = 17) or intestinal cancer (n = 20). There were no significant differences between groups in regards to sex, age, average disease course, average catheter indwelling time, or the distribution of cancer types (P >.05) as shown in Table 1.
Table 1.
Comparison of General Data of Patients in the 2 Groups
| Groups | Study group (n = 80) | Control group (n = 80) | t/χ2 | P-value |
|---|---|---|---|---|
| Sex, n (%) | 0.196 | .657 | ||
| Male | 43 (53.75%) | 49 (61.25%) | ||
| Female | 37 (46.25%) | 31 (38.75%) | ||
| Age, mean (SD) | 62.38 (6.21) | 61.11 (6.03) | 1.27 | .205 |
| Duration of cancer in years, mean (SD) | 4.59 (3.01) | 4.77 (3.52) | 0.313 | .755 |
| Catheter indwelling time in days, mean (SD) | 15.41 (38.3) | 15.50 (4.05) | 0.162 | .871 |
| BMI (kg/m2), mean (SD) | 20.12 (2.15) | 20.08 (2.11) | 0.119 | .906 |
| Diagnosis, n (%) | 5.345 | .721 | ||
| Lung cancer | 22 (27.50%) | 17 (21.25%) | ||
| Intestinal cancer | 18 (22.50%) | 20 (25.00%) | ||
| Gastric cancer | 20 (25.00%) | 18 (22.50%) | ||
| Liver cancer | 5 (6.25%) | 6 (7.50%) | ||
| Breast cancer | 5 (6.25%) | 6 (7.50%) | ||
| Lymphoma | 3 (3.75%) | 3 (3.75%) | ||
| Prostatic cancer | 3 (3.75%) | 3 (3.75%) | ||
| Glioma | 1 (1.25%) | 1 (1.25%) | ||
| Cervical cancer | 1 (1.25%) | 1 (1.25%) | ||
| Nasopharynx cancer | 1 (1.25%) | 1 (1.25%) | ||
| Esophagus cancer | 1 (1.25%) | 0 (0.00%) | ||
| Endometrial cancer | 0 (0.00%) | 3 (3.75%) | ||
| Pancreatic cancer | 0 (0.00%) | 1 (1.25%) |
Complications
Rates of venous thrombosis were significantly lower in the study group (n = 1, 1.25%) compared to the control group (n = 9, 11.25%) (P = .009). The difference in rates of bleeding between the 2 groups was statistically significant (P = .035), with the study group (n = 4, 5.00%) showing a lower incidence than the control group (n = 12, 15.00%). Similarly, catheter-related infections were significantly less common in the study group (n = 3, 3.75%) than in the control group (n = 12, 15.0%) (P = .015). There were no significant differences between the groups in rates of accidental dislodgement (study group: n = 3, 3.75%; control group: n = 4, 5.0%, P = .699) or catheter obstruction (study group: n = 4, 5.0%; control group: n = 3, 3.75%, P = .699) as shown in Table 2. Regarding safety, the incidence of catheter-related complications per 1000 catheter-days was 12.17 in the study group and 32.26 in the control group. The difference in incidence rates was statistically significant (incidence rate ratio [IRR] = 0.38, 95% CI: 0.21-0.68, P = .0013), indicating a lower complication rate in the study group.
Table 2.
Comparison of Complications between the 2 Groups
| Complication | Study group (n = 80), n (%) | Control group (n = 80), n (%) | χ2 | p-value |
|---|---|---|---|---|
| Vein thrombosis | 1 (1.25) | 9 (11.25) | 6.827 | .009 |
| Bleeding | 4 (5.00) | 12 (15.00) | 4.444 | .035 |
| Infection | 3 (3.75) | 12 (15.00) | 5.959 | .015 |
| Accidental dislodgement | 3 (3.75) | 4 (5.00) | 0.149 | .699 |
| Catheter obstruction | 4 (5.00) | 3 (3.75) | 0.149 | .699 |
Patient satisfaction
Patient satisfaction was higher in the study group (mean = 91.36, SD = 8.26) compared to the control group (mean = 88.37, SD = 6.98); however, this difference was not statistically significant, P = .145.
Catheter expenditure
The cost of modified midline catheters (¥ 787.29) was less expensive than PICCs (¥1146.48). As shown in Table 3, the study group (mean = ¥109.25, SD = 12.64) exhibited significantly lower average catheter maintenance costs compared to the control group (mean = ¥126.86, SD = 10.98) (P < .0001). Moreover, the average daily catheter maintenance costs in the study group (mean = ¥7.37, SD = 1.24) were significantly lower than that in the control group (mean = ¥8.65, SD = 1.92), P < .001. The total average catheter maintenance costs were significantly lower in the study group (mean = ¥896.54, SD = 85.46) than in the control group (mean = ¥1273.34, SD = 91.03), P < .0001. For detailed itemized costs of each item, please see Supplemental Digital Content, Table, available at: http://links.lww.com/JNCQ/B460.
Table 3.
Comparison of Catheter Expenditure between the 2 Groups
| Groups | Study group (n = 80), mean (SD) | Control group (n = 80), mean (SD) | χ2 | P-value |
|---|---|---|---|---|
| Average catheter maintenance costs (¥) | 109.25 (12.64) | 126.86 (10.98) | 9.407 | <.0001 |
| Average daily catheter maintenance costs (¥/day) | 7.37 (1.24) | 8.65 (1.92) | 4.993 | <.0001 |
| Total average catheter maintenance costs (¥) | 896.54 (85.46) | 1273.34 (91.03) | 26.99 | <.0001 |
DISCUSSION
In our study, we compared the modified medium-length catheter with the PICC and found no significant difference in the incidence of accidental dislodgement and catheter blockage between the 2 groups. However, the modified medium-length catheter group demonstrated a lower incidence of complications such as venous thrombosis, bleeding, and catheter-related infection, highlighting the benefits of this catheter type. Additionally, it has been reported that the modified medium-length catheter can mitigate complications associated with improper puncture, such as pneumothorax and hemothorax. This catheter also helps to reduce the nursing staff’s workload and alleviate patient discomfort compared to the traditional PICC.8,16,17
In addition to a lower incidence of complications, the modified medium-length catheter also offers advantages in terms of reduced average catheter maintenance costs and total catheter costs. Compared with PICC placement, modified midline catheterization may reduce patient costs by eliminating the need for electrocardiogram and X-ray positioning, which are often required for PICC insertion in clinical practice. Our research confirms that the modified medium-length catheter can alleviate the economic burden on patients to some extent.18 Furthermore, the satisfaction questionnaire revealed that the modified medium-length catheter achieved higher satisfaction ratings. This indicates that the modified medium-length catheter may be a more favorable option for patients.
Several prior studies have investigated the use of medium-length or midline catheters in cancer or palliative care populations. For instance, Gravdahl et al8 reported that midline catheters were associated with lower complication rates and fewer insertion-related adverse events in palliative cancer patients, which aligns with our findings. Similarly, Huang et al13 observed that ultrasound-guided midline catheters reduced the incidence of phlebitis and improved patient satisfaction in patients with maxillofacial tumors. However, other reports such as Giuliani et al9 in a homecare setting found limited evidence of cost advantage, potentially due to different health care systems and outpatient follow-up models. These differences highlight the influence of clinical setting, catheter type, and health care delivery models on outcomes. Our findings support and extend previous evidence by demonstrating that modified midline catheters not only reduce complications but also improve patient satisfaction and reduce costs in hospitalized patients with advanced cancer.
Several studies, including systematic reviews and meta-analyses, found lower rates of catheter-related bloodstream infection and other complications in patients with midline catheters versus PICCs.19-21 Our study observed a significantly lower incidence of thrombosis in the study group compared to the control group. Additionally, the incidence of catheter-related infections was also lower in the study group. Bing et al22 compared modified medium-length catheters and PICCs in terms of thromboembolic and infectious complications, reporting no significant difference in deep vein thrombosis and sepsis rates, suggesting that context and patient selection may affect outcomes. Overall, our results are largely consistent with current literature, supporting the use of modified midline catheters in patients with advanced cancer as a safe and cost-effective alternative to traditional PICCs.
Implications for nursing care quality
From a nursing practice perspective, our findings offer several practical implications. First, midline catheters may represent a safer and more manageable alternative to PICCs for patients with advanced cancer, especially in cases where shorter expected dwell time or reduced tolerance for invasive procedures is anticipated. Second, the reduced complication rates observed with the modified medium-length catheter suggest decreased nursing workload related to managing thrombosis, infection, and dislodgement. Third, improved patient satisfaction scores highlight the importance of catheter selection in the overall patient experience, which is central to nursing care. Finally, as catheter-related costs are a growing concern in many institutions, the cost-saving potential of modified medium-length catheters supports their consideration in evidence-based vascular access decision-making. Nurses should be empowered to advocate for catheter types that best align with patient conditions, clinical goals, and institutional resources.
Limitations
There are several limitations to this study. First, it involved a relatively small sample size and was conducted at a single center, which may limit the generalizability of the findings. Future studies should include larger cohorts and multicenter designs to improve external validity. Second, while catheter-related costs were compared, broader economic outcomes – such as reduced hospitalization duration, management of complication-related events, and long-term health utility – were not assessed. These factors should be evaluated in future cost-effectiveness analyses. Third, although nursing procedures were standardized, variability in nurse training and clinical practice may have influenced outcomes. Further research is warranted to evaluate the modified medium-length catheter’s long-term clinical performance and applicability across other disease populations.
CONCLUSIONS
The modified medium-length catheter presents significant clinical advantages and safety in IV therapy for patients with advanced cancer. It holds promise as a preferred option for IV treatment, offering safer, more effective, and economical solutions that can enhance patients’ experience and comfort during care.
Supplementary Material
Footnotes
The authors declare no conflicts of interest.
This research was supported by the Medical Scientific Research Foundation of Zhejiang Province, Grant NO. 2025KY1397, and Grant NO. 2022KY332.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.jncqjournal.com).
Early Access: August 15, 2025
Contributor Information
Qin Zhou, Email: 15582662@qq.com.
Jieqiong Yan, Email: joanwawa@qq.com.
Yunjie Chen, Email: nbeycyj@163.com.
Bona Wang, Email: bna-wang@ldy.edu.rs.
REFERENCES
- 1.Ogura K, Morizane C, Satake T, et al. Statistics of bone sarcoma in Japan: report from the population-based cancer registry in Japan. Int J Clin Oncol. 2024;29(9):1209-1219. doi:10.1007/s10147-024-02566-4 [DOI] [PubMed] [Google Scholar]
- 2.Wang M, Su X, Hu Y, Yang J. Trends in cancer mortality among the elderly in China, 2005-2035. PLoS One. 2024;19(5):e0302903. doi:10.1371/journal.pone.0302903 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Boland EG, Tay KT, Khamis A, Murtagh FEM. Patterns of acute hospital and specialist palliative care use among people with non-curative upper gastrointestinal cancer. Support Care Cancer. 2024;32(7):432. doi:10.1007/s00520-024-08624-x [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Coronatto LH, Formentin C. Palliative care in glioblastoma patients: a systematic review. Rev Assoc Med Bras (1992). 2024;70(suppl 1):e2024S122. doi:10.1590/1806-9282.2024S122 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Sanchez Canovas M, Garcia Torralba E, Blaya Boluda N, et al. Thrombosis and infections associated with PICC in onco-hematological patients, what is their relevance? Clin Transl Oncol. 2024;26(12):3226-3235. doi:10.1007/s12094-024-03548-8 [DOI] [PubMed] [Google Scholar]
- 6.Lu A, Hu M, Qi X, Zhao Y, Huang Y. A retrospective cohort study of implantable venous access port-related and peripherally inserted central catheter-related complications in patients with hematological malignancies in China. SAGE Open Med. 2024;12:20503121241257190. doi:10.1177/20503121241257190 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Anderson NR. Midline catheters: the middle ground of intravenous therapy administration. J Infus Nurs. 2004;27(5):313-321. doi:10.1097/00129804-200409000-00005 [DOI] [PubMed] [Google Scholar]
- 8.Gravdahl E, Steine S, Augestad KM, Fredheim OM. Use and safety of peripherally inserted central catheters and midline catheters in palliative care cancer patients: a retrospective review. Support Care Cancer. 2023;31(10):580. doi:10.1007/s00520-023-08045-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Giuliani J, Andreetta L, Mattioli M, et al. Intravenous midline catheter usage: which clinical impact in homecare patients? J Palliat Med. 2013;16(6):598. doi:10.1089/jpm.2012.0615 [DOI] [PubMed] [Google Scholar]
- 10.Souri Y, Hernandez Cancino EF, Kerndl H, Hyhlik-Duerr A, Gosslau Y. Clinical evaluation of the PowerGlide Pro midline catheter- dwell time, complications and outcomes for various medications including prostaglandins. Langenbeck’s Arch Surg. 2024;409(1):363. doi:10.1007/s00423-024-03546-y [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Nickel B, Gorski L, Kleidon T, et al. Infusion Therapy Standards of Practice, 9th Edition. J Infus Nurs. 2024;47(1S):S1–S285. doi:10.1097/nan.0000000000000532 [DOI] [PubMed] [Google Scholar]
- 12.Xu H, Liu Y, Yao J. The study of catheter/vein diameter ratio in predicting symptomatic PICC-related thrombosis in patients with hematological tumors (in chinese). J Nurs Sci. 2022;37(13):44-48. doi:10.3870/j.issn.1001-4152.2022.13.044 [Google Scholar]
- 13.Huang Q, Wu W, He X, Deng Y, Chen Y, Gu W. Application of midline catheter placed under ultrasound guidance in intravenous therapy for oral and maxillofacial tumor. Sichuan da xue xue bao Yi xue ban = J Sichuan Univ Med Sci Ed. 2023;54(4):777-781. doi:10.12182/20230760202 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Wang R, Zhao Y. Application of ultrasound-guided Satinger technique in the placement of improved medium-length catheter in patients with esophageal cancer (in chinese). Tumor Basis and Clinic. 2021;34(01):69-72. doi:10.3969/j.issn.16735412.2021.01.017 [Google Scholar]
- 15.Zhang M. Application effect of improved medium-length catheter guided by ultrasound in patients with advanced malignant tumor (in chinese). Med Innov China. 2022;19(19):113-114. doi:10.3969/j.issn.1674-4985.2022.19.027 [Google Scholar]
- 16.Kumar Upadhyay A, Prakash B, Shekhar S, Kumar A, Prakash A. Embolization of a fractured peripherally inserted central catheter to pulmonary arteries: a sporadic life-threatening phenomenon. Cureus. 2023;15(8):e43044. doi:10.7759/cureus.43044 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Lin L, Li W, Chen C, Wei A, Liu Y. Peripherally inserted central catheters versus implantable port catheters for cancer patients: a meta-analysis. Front Oncol. 2023;13:1228092. doi:10.3389/fonc.2023.1228092 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Heggie R, Jaiswal N, McCartney E, et al. Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value Health. 2024;27(1):7-14. doi:10.1016/j.jval.2023.09.2996 [DOI] [PubMed] [Google Scholar]
- 19.Swaminathan L, Flanders S, Horowitz J, Zhang Q, O’Malley M, Chopra V. Safety and outcomes of midline catheters vs peripherally inserted central catheters for patients with short-term indications: a multicenter study. JAMA Intern Med. 2022;182(1):50-58. doi:10.1001/jamainternmed.2021.6844 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Chen X, Liang M. A meta-analysis of incidence of catheter-related bloodstream infection with midline catheters and peripherally inserted central catheters. J Healthc Eng. 2022;2022(1):6383777. doi:10.1155/2022/6383777 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Urtecho M, Torres Roldan VD, Nayfeh T, et al. Comparing complication rates of midline catheter vs peripherally inserted central catheter: a systematic review and meta-analysis. Open Forum Infect Dis. 2023;10(2):ofad024. doi:10.1093/ofid/ofad024 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Bing S, Smotherman C, Rodriguez RG, Skarupa DJ, Ra JH, Crandall ML. PICC versus midlines: comparison of peripherally inserted central catheters and midline catheters with respect to incidence of thromboembolic and infectious complications. Am J Surg. 2022;223(5):983-987. doi:10.1016/j.amjsurg.2021.09.029 [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.