CVCs Versus Midline Catheters

NCT ID: NCT06884176

Last Updated: 2026-01-13

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-31
• Study Completion Date: 2027-01-31

Brief Summary

The goal of this clinical trial is to learn if midline catheters can reduce adverse patient outcomes in adult patients requiring a single vasopressor. The main questions the study aims to answer are:

• Do midline catheters reduce the rates of catheter-related bloodstream infections as compared to central venous catheters?
• Do midline catheters reduce the rates of deep venous thrombosis as compared to central venous catheters? Researchers will compare midline catheters to central venous catheters to see if there is a reduction in these events.

Participants will be randomized to the midline catheter group or the central venous catheter group. The catheters will be part of standard of care for vasopressor therapy. The participants will be followed for 30 days.

Detailed Description

Within the United States, around 5 million central venous catheters (CVCs) and 150 million peripheral catheters are inserted annually. A 2015 surveillance survey across 10 U.S. states revealed that 4% of hospitalized patients had 1 or more healthcare-associated infections, with 25.6% reported as device-associated infections. Device-associated infections included catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infections, and ventilator-associated pneumonia. In addition to increased rates of CRBSI, CVCs are associated with upper extremity deep venous thrombosis (DVT). Peripherally inserted central catheters (PICCs) have previously been proposed as an alternative to CVCs to avoid these complications. However, due to the increasing lumen diameter of PICCs, increased rates of catheter-related thrombosis as compared to CVCs have been reported. In contrast to PICCs where the catheter tip ends at the cavo-atrial junction near the right atrium, midline catheters are peripheral vascular devices inserted into the upper extremity veins that terminate at or below the axillary vein. As midlines terminate prior to the large vasculature of the chest, studies have demonstrated lower rates of CRBSI or DVTs as compared to the reported incidence of such complications with PICCs or CVCs. To date, there have been no large-scale randomized control trials comparing CVC and midline complication rates, including thrombosis, CRBSI, central-line associated readmission, and overall patient mortality.

The authors plan to conduct a parallel, 2-group, open-label randomized control trial at a single urban academic center. A convenience sample of adult patients will be obtained over the course of 1 year. Patients with single vasopressor requirements will be subject to enrollment. Patients will be enrolled in the study by clinicians participating in their care who are involved in the placement of the catheter (midline or CVC). Informed consent will take place in the emergency department (ED) prior to the catheter placement. Clinicians will ask patients who are being treated whether they are interested in the study. Study team members will then approach interested patients to obtain consent for the research.

Conditions

Central Venous Catheter; Midline Catheter; Complication of Catheter

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

central venous catheter

If randomized to this group, patients will receive a triple lumen central venous catheter

Group Type: ACTIVE_COMPARATOR

Ultrasound Guided Central Venous Catheter

Intervention Type: DEVICE

Patients randomized to this arm will receive an ultrasound guided central venous catheter. The catheter is 20cm in length.

Midline catheter

If randomized to this group, patients will receive a single lumen midline catheter

Group Type: ACTIVE_COMPARATOR

Ultrasound Guided Midline Catheter

Intervention Type: DEVICE

Patients randomized to this arm will receive an ultrasound guided midline catheter. The catheter is 8-10cm in length.

Interventions

Ultrasound Guided Central Venous Catheter

Patients randomized to this arm will receive an ultrasound guided central venous catheter. The catheter is 20cm in length.

Intervention Type: DEVICE

Ultrasound Guided Midline Catheter

Patients randomized to this arm will receive an ultrasound guided midline catheter. The catheter is 8-10cm in length.

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Patients over 18 years of age being treated in the Emergency Department at Jacobi Medical Center

• Have an upper extremity (left or right arm) that can accept a midline catheter
• Able to provide consent (patient or health care proxy)
• Clinical team believes the patient will require inpatient admission at the time of needing intravenous access
• Requires a central line or midline catheter as an expected requirement of care
• Patients requiring a single vasopressor due to hypotension

Exclusion Criteria

• Patients in cardiac arrest (prior to achieving ROSC)
• Patients with infection or burns at both upper extremities
• Patient expected to be discharged from the hospital within 24 hours
• Prisoner
• Pregnancy
• Children less than 18 years of age
• The patient is known or is suspected to be allergic to materials contained in the device
• Patients known to have bacteremia
• Patients with existing central venous catheter
• Patients without the ability to consent (or no health care proxy to consent)

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Jacobi Medical Center

OTHER

Sponsor Role: collaborator

Albert Einstein College of Medicine

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sandeep Dhillon, MD

Role: PRINCIPAL_INVESTIGATOR

Jacobi Medical Center, Albert Einstein College of Medicine

Locations

Jacobi Medical Center

The Bronx, New York, United States

Countries

United States

Central Contacts

Ariella S Gartenberg, MD

Role: CONTACT

ariella.applebaum@gmail.com

2017871762

Sandeep Dhillon, MD

Role: CONTACT

skdhillon91@gmail.com

7189185800

Facility Contacts

Ariella Gartenberg, MD

Role: primary

ariella.applebaum@gmail.com

201-787-1762

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Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, Lynfield R, Maloney M, McAllister-Hollod L, Nadle J, Ray SM, Thompson DL, Wilson LE, Fridkin SK; Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014 Mar 27;370(13):1198-208. doi: 10.1056/NEJMoa1306801.

Reference Type: BACKGROUND

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Other Identifiers

2025-16724

Identifier Type: -

Identifier Source: org_study_id