Frequency of IV Cannula Replacement
Peripheral intravenous cannulas in adults should be replaced every 72-96 hours to prevent phlebitis and other complications. 1
Evidence-Based Recommendations for Different Types of IV Cannulas
Peripheral Venous Catheters
- In adults, peripheral venous catheters should be replaced and relocated no more frequently than every 72-96 hours 1
- For pediatric patients, peripheral catheters should not be routinely replaced but left in place until IV therapy is completed, unless complications (such as phlebitis or infiltration) occur 1
- Catheters inserted under emergency conditions (when aseptic technique may have been compromised) should be replaced within 48 hours 1
Central Venous Catheters
- Central venous catheters (including peripherally inserted central catheters) should not be routinely replaced solely to reduce infection risk 1
- Instead, they should be removed when no longer clinically necessary or when complications develop 1
Arterial Catheters
- No specific recommendation exists for routine replacement of arterial catheters 1
- They should be removed as soon as they are no longer needed 1
Associated Components Replacement Schedule
Administration Sets
- Standard IV tubing and add-on devices should be replaced no more frequently than every 72-96 hours 1
- Tubing used for blood, blood products, or lipid emulsions should be replaced within 24 hours of initiating the infusion 1
- Tubing for propofol infusions requires more frequent changes - every 6 or 12 hours according to manufacturer recommendations 1
Needleless Components
- Change needleless components at least as frequently as the administration set (every 72-96 hours) 1
- Clean injection ports with 70% alcohol or an iodophor before accessing the system 1
Clinical Considerations and Pitfalls
Phlebitis Prevention
- The primary reason for routine replacement of peripheral cannulas is to prevent phlebitis, which occurs most commonly after 72 hours 2, 3
- Studies show that elective re-siting of IV cannulas every 48 hours significantly reduces the incidence of peripheral venous thrombophlebitis compared to leaving them in place until clinical indications develop 2, 3
Emerging Evidence for Clinically-Indicated Replacement
- Some recent research suggests that replacing peripheral IV cannulas only when clinically indicated (signs of phlebitis, infiltration, occlusion, or infection) rather than routinely may be safe 4
- This approach could reduce the total number of cannulations per patient, decreasing costs and patient discomfort 4
- However, this evidence has not yet been incorporated into major guidelines, which still recommend the 72-96 hour replacement schedule 1
Cost Considerations
- Extending peripheral IV dwell time from 72 to 96 hours appears safe and may result in significant cost savings without increasing infection rates 5
- A Cochrane review found no evidence that changing administration sets more often than every 96 hours reduces bloodstream infection incidence 6
Special Circumstances
- Always inspect the IV site daily for signs of complications 1
- When showering, protect the catheter and connecting device with an impermeable cover to prevent introducing organisms into the catheter 1
- Designate trained personnel for insertion and maintenance of intravascular catheters to minimize complications 1