FIDLINE: femorally inserted midline catheter. Retrospective evaluation of clinical outcomes in acute care patients

INTRODUCTION: Venous access device (VAD) placement is essential for inpatient care but may be challenging when upper extremity veins are unavailable. Although femorally inserted central catheters are frequently used, a central device is not always required. Femorally inserted midline catheters with a peripheral tip represent a feasible alternative in selected patients. Given the absence of standardized nomenclature, the term "Fidline" was introduced as a fusion of "Femorally inserted peripheral catheter" and "Midline." This retrospective study evaluates indications, feasibility, and complications associated with this device. METHODS: A retrospective case series was conducted using the institutional database to identify all Fidline catheters (FCs) inserted over a 12-month period. A total of 57 patients underwent FC placement; three were excluded because of unavailable post-implantation clinical documentation, leaving 54 patients for analysis. Clinical records were reviewed to collect data on catheter related thrombosis (CRT) and catheter-associated bloodstream infection (CABSI). All FCs (midline, 25 cm length 4 FR single lumen) were implanted in the "superficial femoral vein" at mid-thigh according to the SIF protocol. RESULTS: Fifty-four patients were included (median age 85 years; IQR 69.8-88), with a female predominance (53.7%) and the median length of hospital stay was 17.5 days (IQR, 11.0-32.3). Most patients were admitted to medical wards (57.4%) and 50% had a previously placed VAD. Median catheter dwell time was 8 days (IQR 4.0-13.0), with a median of 5.5 days from admission to catheter placement. During 506 catheter-days, one symptomatic CRT and one CABSI occurred (1.97/1000 catheter-days). At hospital discharge, the catheter remained in situ in 26 patients (48.1%). CONCLUSIONS: FC appears to be a safe and viable VAD option, associated with a low observed rate of major complications in this cohort.