What is the maximum duration a Peripherally Inserted Central Catheter (PICC) line can remain in place?

From the Guidelines

A PICC line should not remain in place for more than 3-6 months, as recommended by the most recent guidelines 1. The decision to remove a PICC line is based on clinical judgment rather than a strict time limit. Some key factors to consider when determining the maximum time a PICC line can be in place include:

• The patient's condition and the reason for placement
• The development of complications such as infection, occlusion, or thrombosis
• The need for regular flushing with saline or heparin and sterile dressing changes to maintain patency and prevent complications
• The availability of alternative vascular access options, such as tunneled, cuffed catheters or ports, which may be more suitable for long-term use 1. According to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) 1, PICCs are rated as appropriate when at least 3 months of treatment are proposed, but ports are preferred for durations of 6 or more months. It is essential to weigh the benefits of continued PICC line use against the potential risks and to consider alternative options for patients requiring long-term vascular access. Regular assessment and monitoring of the PICC line are crucial to prevent complications and ensure patient safety. In critically ill patients, the appropriateness of PICC insertion differs from that in general medical patients, with a higher threshold for PICC use due to concerns about hemodynamic stability, infection, and thrombosis 1.

From the Research

Maximum Time a PICC Line can be in

• The maximum time a PICC line can be in is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
• However, study 5 mentions that the cost-effectiveness of PICCs and totally implanted vascular access ports (PORTs) was compared for medium- to long-term chemotherapy, with dwell times ranging from 3-12 months.
• The study found that PICCs were associated with lower costs and higher complication rates than PORTs, but the maximum duration of PICC placement was not specified 5.
• Study 6 discusses the choice of vascular access device for cancer patients, including PICCs, and mentions that PICCs may be a better choice for patients who need short-term chemotherapy or continuous short-term supportive therapy, but does not provide information on the maximum time a PICC line can be in 6.
• Overall, there is no clear evidence in the provided studies to determine the maximum time a PICC line can be in, and further research may be needed to answer this question.