{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:45:40Z","timestamp":1791888340430,"version":"4.3.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypertonic saline (HTS) has been utilized in the treatment of several critical conditions including severe hyponatremia and elevated intracranial pressure. Current practice requires that HTS be administered through a central venous catheter (CVC). Midline catheters (MC) are a type of peripheral venous catheter (PIVC) placed in a large peripheral vein distal to the axillary vein. There are a few comprehensive studies investigating the efficacy of utilizing MCs for the administration of long-term HTS.\u202f<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective single center study performed at a tertiary care academic hospital, of patients admitted to the ICU for the administration of HTS through a MC. Data collected from 2019-2023 through a chart review of electronic medical records and recorded in REDCap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 138 patients who received HTS via a MC were included in the analysis. Subjects were predominantly male (69.57%) and black (59.42%). The median age of the patient was 57 years \u00b1 14.4 years old. The admission diagnoses included intracranial hemorrhage accounting for 67.39%, followed by altered mental status at 18.12%, trauma at 12.32% and sepsis at 7.25%.<\/jats:p>\n                    <jats:p>The concentrations of the HTS infusions were 2% NaCl in 54 patients, 3% NaCl in 82 patients, and 23% NaCl in 2 patients. The average duration of a continuous HTS infusion was 14\u2005h and 34\u2005min \u00b1 15\u2005h and 17\u2005min. The average dosage rate was 86.03\u2009\u00b1\u200974.43\u2005mL\/h. Only one patient experienced thrombophlebitis. Thrombosis developed within the midline catheters for 5 patients. No complications related to drug extravasation or deep vein thrombosis were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results showed minor adverse events suggesting that MC may be a safe alternative for the administration of long-term HTS infusions. Midline catheters should be considered when weighing risk and benefits of HTS administration in the management of elevated intracranial pressure and severe hyponatremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261432139","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T11:09:06Z","timestamp":1774264146000},"page":"1100-1104","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Safety of Hypertonic Saline Administration Through Midline Catheters"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5076-0919","authenticated-orcid":false,"given":"Suhali","family":"Kundu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"},{"name":"Greater Baltimore Medical Center Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8144-7663","authenticated-orcid":false,"given":"Seda","family":"Akben","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Shipley","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin Dell Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasa","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Yale New Haven Hospital"},{"name":"Yale School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9124-8025","authenticated-orcid":false,"given":"Katrina","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9126-4789","authenticated-orcid":false,"given":"Daniel","family":"King","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Davison","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5101-2162","authenticated-orcid":false,"given":"David","family":"Yamane","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"},{"name":"Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2018.12.046"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.11.032"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617702590"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500964"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir257"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/685481"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","unstructured":"Stocchetti N Longhi L Valeriani V. 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