Difference Between PICC and Midline (With Table)

In the medical field, there are many ways to administer medicine to a patient and one of the many ways is to administer the medicine directly into the bloodstream intravenously. To administer drugs and medicine intravenously for a longer period of time for a substantial treatment, the catheter is an indispensable tool.

PICC vs Midline

The difference between PICC and Midline is that PICC is a longer catheter that is directed directly into a pulmonary axillary artery while midline is a shorter catheter that is directed from the arm and ends in an area beside the chest in the arm right close to the armpit. Their main differentiating factor except their length is that the point where the catheter leads to and becomes the deciding factor of its uses.

PICC is a form of a catheter that measures anywhere between 25-60 cm in its measurement of length. This defines the purpose for which it is used medically, it is used for direct delivery of medicine into the heart and near the veins of the heart. Its major purpose is to be used in cancer treatment, liquid nutrition for terminally ill people, applying the medication, and delivering medication for infectious diseases.

Midline is another form of a catheter that measures anywhere between 6-25 cm depending on the person it is being applied to, its characteristic shorter length defines its purposes and uses. This catheter is used to deliver medicine directly into the bloodstream in an artery right below the armpit. Then this medication gets delivered to the entire body. It is generally used for long-term treatment and can be resolved in more than 6 days, henceforth it cannot be favourable in every situation.

Comparison Table Between PICC and Midline

Parameters of ComparisonPICCMidline
Safety and HealthChances of complications in healthLess likely to create complications
LengthIt ranges from 25-60 cms in lengthIt ranges from 6-25 cms in length
UsesIt is generally used in chemotherapyIt is generally used in cardiological therapy
LocationIt is usually inserted through the vein near the elbow of a person and put all the way into the pulmonary axillary arteryIt is usually inserted through a vein near the elbow above it and it is put all the way till under the armpit
Veins of InsertionPICC is put through the basilic veinMidline is put into the cephalic vein

What is PICC?

PICC or Peripherally inserted central catheter line is an intravenous catheter line. This is generally used in chemotherapy, antibiotic treatment in a patient with infectious diseases and is used in shorter treatments as it can easily provide the blood directly into the system of the patient and thus it can take effect quickly. PICC is also used in many other fields such as blood drawing and blood transfusion.

Although regarded as a safe form of intravenous treatment, complications can arise which include but are not limited to blood clotting and nerve damage. Such complications require immediate attention from medical staff as they can cause major complications down the line. Dealing with such complications with the IV may require the medical professional to remove the catheter line and reinsert it in a different vein of the body or using a different catheter altogether.

This form of IV, it requires some preparation, that being said, it needs some form of scan to pinpoint the actual location of the said vein. Usually, ultrasonography is used with ultrasonography jelly. The professional finds it easier to locate the vein this way. A needle is used to create an opening to the vein and with the help of wire and a thicker needle, the catheter is placed into the said vein. Then the location of the incision is sealed off with proper airtight sterile dressing to prevent complications and infections.

What is Midline?

A midline is a form of the long peripheral catheter which is used intravenously to provide medication and/or nutrition to the patient. It has a very characteristic short length which is around 6-25 cm, useful in many cases for long-term treatment of a patient or long periods ranging from a few days up to a week for a patient in critical condition or an emergency room.

The advantage midline has is that it is compatible with patients with Difficult Venous Access (DIVA), or patients that require more than 6 days to a month of treatment. Peripherally compatible infusates are mostly nonvesicant drugs, drugs with osmolarity <600 mOsm, parenteral nutrition and they should have acidity within the range of 5-9 pH. Mainly it is used for antibiotherapy. Its main uses are based on the uses in cardiology, orthopaedics, pulmonology, infectious diseases, nephrology, and many more fields. It is cost-effective, less painful, has more mobility, and thus is useful in many causes and treatments.

Proper care must be taken of the area of incision, as it can get infected very easily so proper dressing is important.

Main Differences Between PICC and Midline

  1. Midline is considerably shorter in length than PICC, which is 6-25 cms for the former and 25-60 cms for the latter.
  2. The usage of the two variants of the catheter is that different Midline is used on long term treatment and PICC is used in shorter treatments like chemotherapy.
  3. Midline is put into the cephalic vein while PICC is put inside the basilic vein.
  4. PICC is put up to a pulmonary artery and Midline is put up to the axillary artery underneath the armpit.
  5. Long-term exposure to PICC may create complications in health while midline can be used for a longer time as chances of infections are low.

Conclusion

During medical treatment, it is important for both the professional as well as the patient, to know what is happening to them and what is needed to be done. Therefore, as a matter of information it is important to be knowledgeable about what catheters are used for and at which situation. This helps the medical professionals make informed decisions and thus take proper steps in treating a person. For example, what will be a treatment for a short-term infection is dependent on the doctor’s judgment so the patient will have some idea about how the catheter will be used and what kind of intravenous catheter will be used. For a short-term treatment PICC is valuable but for a slower, longer treatment midline is extremely important.

In treatments like chemotherapy, PICC is used because of its longer length and deeper reach so the actual medications and chemicals can reach the tumour while in treatments of diseases that have a longer recovery period midline is impeccable for its stability.

References

  1. https://www.proquest.com/openview/d1e00032b87f1e96647b1457dcc0b46a/1?pq-origsite=gscholar&cbl=30130
  2. https://www.tandfonline.com/doi/full/10.3109/0284186X.2013.773072?scroll=top&needAccess=true
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