Adverse reactions associated with midline catheters--United States, 1992-1995.

The midline catheter is a peripherally inserted 6-8-inch catheter that may be used in patients requiring intermediate duration (i.e., several weeks) of physiologically compatible intravenous (IV) therapy. Unlike conventional short peripheral IV catheters, the midline catheter does not require changes every 48-72 hours. Midline catheters can be inserted at the bedside by a trained health-care worker, in contrast to subclavian, jugular, or femoral central venous catheters, which require insertion by a physician (often in an operating or procedure room) and usually are associated with more serious complications. Since 1990 (1), the Food and Drug Administration (FDA) has received reports of acute hypersensitivity-like reactions temporally associated with insertion of midline catheters made from Aquavene (Landmark, Menlo Care, Menlo Park, California), an elastomeric hydrogel material that becomes hydrated and expands after catheter insertion (FDA, unpublished data, 1995; 1). This report describes four episodes of such reactions during 1992-1995, including one in a patient in a home-health-care setting (patient 1) and three among patients at a large university-affiliated hospital (patients 2-4).