Midline catheters were associated with significantly lower failure and complication rates compared with long peripheral catheters among patients undergoing bariatric surgery, with complication rates of 13% vs 28% respectively, according to a randomized controlled trial of 224 patients in China.
Device failure also occurred less frequently with midlines at 11% vs 21% with long peripheral catheters. Midline catheters provided longer dwell times with a median of 7 days compared with 5 days for peripheral catheters.
The need for additional vascular access was lower with midlines at 5% compared with 16% with long peripheral catheters. Patient satisfaction at removal was also higher in the midline group.
The trade-off was insertion time - midlines required a median of 17 minutes vs 5 minutes for peripheral catheters, though first-attempt success rates were similar at 93% vs 88%.
Infiltration and extravasation, the most common complications, occurred in 5% of patients with midlines compared with 15% with peripheral catheters. No infections were reported in either group.
The single-center study was conducted by Linfang Zhao and Xiaohui Yang from Zhejiang University School of Medicine, China, and colleagues. It included patients undergoing laparoscopic sleeve gastrectomy with mean BMI of 39 kg/m². All insertions used ultrasound guidance by experienced nurses. Patients were randomized 1:1 between September 2023 and January 2024.
All patients remained hospitalized for a median of 7 days, reflecting standard protocols in Chinese tertiary hospitals where bariatric surgery requires extended monitoring for cardiopulmonary and metabolic stability.
Limitations include single-center design and routine 7-day hospitalization that may not reflect practices in regions where earlier discharge is common. Findings may not be generalizable to other populations. Cost-effectiveness was not assessed. The researchers recommended multicenter studies with larger and more diverse populations.
The investigators reported no external funding or competing interests.
Source: Scientific Reports