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Short Midline or Central Venous Catheter for Difficult IV Access?
Short Midline or Central Venous Catheter for Difficult IV Access?
Posted
on 22 September 2026
Study Overview
Patients with difficult intravenous access may experience repeated insertion attempts, treatment delays and discomfort. When standard peripheral access is unsuccessful, clinicians may consider either a short midline catheter or a central venous catheter.
This randomised pilot trial assessed whether a larger clinical trial comparing these two devices would be feasible. Thirty adult patients requiring intravenous therapy for 4-29 days were randomised to receive either a 10 cm short midline catheter or a central venous catheter.
Key Findings
The study met most of its predefined feasibility targets, including recruitment, retention, adherence and complete data collection.
However, more than half of participants required two or more skin punctures, meaning the insertion-attempt target was not achieved.
Median catheter dwell time was 5.5 days for short midlines and 4 days for central venous catheters.
Catheter malfunction occurred more frequently with short midlines than with central venous catheters: 58% compared with 7%.
No catheter-related infections or thromboses were identified in either group.
Implications
The findings show that a larger randomised trial comparing these devices is achievable, but important practical issues must be addressed first.
The higher rate of short midline malfunction is noteworthy, although this small pilot study was not designed to determine which device is clinically superior. Larger studies are needed to compare reliability, complications, patient experience and resource use before firm recommendations can be made.
The study also reinforces the importance of selecting vascular access based on the patient’s treatment needs, expected therapy duration and individual risk factors rather than relying on a single device for every patient with difficult access.
 "Short Midline or Central Venous Catheter for Difficult IV Access?")
