Risk of catheter-related bloodstream infection associated with midline catheters compared with peripherally inserted central catheters: A meta-analysis.
Huapeng Lu, Yeru Hou, Jiejie Chen and 6 others
PMID 33372316WHAT IT FOUND
Midline catheters and PICCs showed no significant difference in bloodstream infection risk overall.
Subgroup and sensitivity results were inconsistent, so do not assume one device is safer for all patients.
Key findings
01The overall bloodstream infection risk was not significantly different between midline catheters and PICCs.
02Bloodstream infection occurred in 0.58% of midline catheter patients (40/6,900) and 0.48% of PICC patients (127/26422).
03When four poor-quality studies were removed, the analysis showed lower infection risk with midline catheters.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis included only 10 studies, one of which was a conference abstract, and four were rated poor quality. The overall result changed when poor-quality or large studies were removed, so the finding is not stable. Most participants were adults, with few children, so conclusions are limited for children. Only published studies were included, so unpublished results could be missing. The included studies were mostly retrospective cohorts rather than randomised trials.
Declared interests
The authors declared no financial or personal relationships that could influence the work. The study was funded by the First Affiliated Hospital of Xi'an Jiaotong University.
The easy way to misread this
Do not conclude that midline catheters are safer than PICCs for bloodstream infection. The primary analysis across all studies found no significant difference, and subgroup and sensitivity analyses were inconsistent.