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Evaluation of processes, outcomes, and use of midline peripheral catheters for the purpose of blood collection

28 January 2021
Volume 30 · Issue 2



Results added knowledge on use of midline catheters (MCs) for blood sampling.

Using MCs for blood withdrawal resulted in low rates of hemolysis (0.69%).

Dwell time was longer in those who had blood drawn from their MC.

Nurse practices for blood sampling from MCs varied and learned from other nurses.


Blood withdrawal from midline catheters (MCs) is done clinically, but no studies were found evaluating outcomes from this procedure, nor were clinical guidelines found. Drawing blood samples from short peripheral catheters is associated with higher hemolysis rates.


A prospective, observational, mixed methods study was used to evaluate outcomes from using MCs for blood withdrawal. Focus group sessions were held to evaluate nurses' practices for this procedure.


Data were collected over 3 months on 397 MCs in 378 patients. Hemolysis rates when the MC was used for blood withdrawal was 0.69% in 1021 tests. More than half had blood specimens drawn through the MC, and the time known for the successful withdrawal was on average 64 ± 85 hours. Mean dwell time for all MCs was 108.5 ± 98 hours, and when MCs were used for blood withdrawal, mean dwell time was 127.19 ± 109.13 hours and for MCs not used for blood withdrawal, 88.34 ± 79.86 hours (P < 0.001). In 338 patients who received therapy through their MC (n = 338), 87% completed intended therapy: 88% with blood withdrawal and 81% without blood withdrawal. Qualitative analysis from focus groups demonstrated wide variation in practice for blood sampling from MCs, and most learned techniques from their preceptors, other nurses, or patients.


Findings indicated that blood withdrawal from one specific type of MC had low rates of hemolysis, increased dwell time, and completion of therapy. More studies are needed to determine best practices for blood sampling through various types of MCs and outcomes.

Midline intravenous catheters (MCs) have been in clinical use since the 1950s and are commonly used as an alternative for intravenous (IV) access to short peripheral IV catheters and central venous access devices.15 Use of MCs is associated with lower phlebitis rates and infections than for central venous catheters (CVCs) and can be inserted without the need for radiologic verification.2,6 Indications for using MCs are to administer intravenous medications and infusions for up to 30 days and are recommended when treatment is anticipated for 56 days or for long-term therapy in patients with limited IV access.2,46 In addition to MC use for infusions and medication administration, using the MC for blood sampling has been included as an indication for those who have difficult IV access.6 This option may reduce need for direct venipuncture in patients who have MCs with ongoing or frequent blood sampling needs for testing.6

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