Midline Catheters as an Alternative for Central Venous Catheters in Venous Pressure Monitoring: A Single Center Experience

Brendan Sweeney, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Justin Kim, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA.
Ariana Adnani, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Huma Saleem, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Seda Akben, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Yin Rong Teo, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Eduard Shaykhinurov, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Maria Wu, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Rishika Bheem, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Samita Islam, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Danielle Davison, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Katrina Hawkins, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Daniel King, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.
Sasa Ivanovic, Department of Pulmonary and Critical Care Medicine, Yale New Haven Hospital, New Haven, CT, USA.
David P. Yamane, Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

9-5-2025

Journal

Journal of intensive care medicine

DOI

10.1177/08850666251368867

Keywords

cardiac output; central venous catheter; hemodynamic monitoring; hemodynamics; quality; volume status

Abstract

PurposeMidline catheters (ML) are long peripheral intravenous catheters placed in an upper extremity above the antecubital fossa via the basilic, cephalic, or brachial veins. These provide safe and comfortable long-term vascular access for critically ill patients. Central venous pressures (CVP) are obtained from central venous catheters (CVC) and are often used as resuscitation parameters. Given the proximity of ML to the axillary vein, we investigated if midline venous pressure (MVP) is comparable to CVP.MethodsThis is an observational study conducted in adult critical care patients at a tertiary academic center. Inclusion criteria were patients with a CVC in the subclavian or internal jugular veins and a ML in place as part of standard ICU care. Pressure measurements were recorded from both catheters every 15 min over a 60-min period. Demographic, clinical, and physiological data points were collected. Continuous variables were analyzed using the t-test. Pearson correlation was used to evaluate the relationship between the paired variables.ResultsWe enrolled 50 patients with 5 pressure measurements taken per patient (n = 250). The mean MVP and CVP were 10.6 ± 6.4 mm Hg and 9.1 ± 6.3 mm Hg, respectively (P < .001). In Bland Altman analysis, the mean bias was -1.48 ± 3.99 mm Hg with limits of agreement of -9.3 mm Hg to 6.3 mm Hg. The Pearson correlation coefficient was 0.8 (P < .001).ConclusionsOur study investigated MVP as a correlate of CVP. Our results show a mean bias of -1.48 ± 3.99 mm Hg and a strong positive Pearson correlation coefficient of 0.8 between the MVP and the CVP. The large limits of agreement indicate MVP and CVP are not interchangeable. Despite this, clinically significant pressure values from CVCs and MLs trend similarly.

Department

Anesthesiology and Critical Care Medicine

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