https://doi.org/10.1177/1129729820982870 The Journal of Vascular Access 1–7 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1129729820982870 journals.sagepub.com/home/jva JVA Te Journal of Vascular Access Introduction Venous access is one of the basic, yet critical components of patient care in any health care setting. Right choice of venous access device in a patient can provide uninter- rupted therapy with consequent reduction in discomfort, morbidity, length of stay and costs incurred. 1 Peripheral Intravenous Cannulas (PIVC) are used in patients requir- ing short term access for 72 to 96 h and Centrally inserted Central Catheters (CICC) are inserted in patients who require multiple infusions, critically ill and cared in inten- sive care units. 2 There is another subset of patient population suffering from high risk medical and surgical conditions, with multiple comorbidities and chronic infections treated in the wards. These patients require venous access for 1–4 weeks and their medications are hyperosmolar and irritant, prone to cause chemical phlebitis if infused through PIVC. Long Peripheral Catheters (LPC) are ideal Conventional central venous catheters as tunnelled mid-clavicular midline catheters: Description of novel application and outcome analysis Sivashanmugam Thiyagarajan and Charulatha Ravindran Abstract Background: Long peripheral catheters are the ideal devices for intermediate venous access (1–4 weeks). However due to non-availability and cost constraints, these lines are not widely adapted in developing countries. In this clinical report we describe a technique of using conventional Central Venous Catheters as Midclavicular midlines for intermediate venous access and present the outcome analysis of such catheters in the last 2 years from our institute. Methods: A single lumen conventional central venous catheter (5 Fr, 20 cm) was introduced through the deep veins of the upper arm, 1 to 1.5 cm distal to the axillary crease. The catheter was tunnelled for a distance of 5 to 7 cm to exit from Dawson’s green zone to reduce the incidence of Midline Associated Blood Stream Infection. Patients were followed up by trained staff nurses and outcome parameters were recorded. Results: Seventy six patients were enrolled and 72 patients underwent successful cannulation and completed the outcome analysis. Administration of intravenous antibiotics and chemotherapy were the commonest indications. The device served the intended duration of therapy in 66 (92%) patients for a median number of 12 (6–20) catheter days. Device related blood stream infection was 1.24/1000 catheter days and catheter related thrombosis rate was 8.3%. Conclusion: Conventional Central Venous Catheters can be effectively used as tunnelled Midclavicular midline catheters in low resource settings. The successful outcome analysis has to be confirmed by larger studies. Keywords Venous access, intermediate, axillary vein, tunnelled catheters, cost effective Date received: 5 July 2020; accepted: 29 November 2020 Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth Deemed University, Puducherry 607402, India Corresponding author: Charulatha Ravindran, Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth Deemed University, Room number 211, Puducherry 607402, India. Email: ravindrancharulatha@gmail.com 982870JVA 0 0 10.1177/1129729820982870The Journal of Vascular AccessThiyagarajan and Ravindran research-article 2020 Original research article