What is the maximum duration a peripheral intravenous (IV) catheter can remain in place?

Duration of Peripheral Intravenous Catheter Placement

In adults, peripheral intravenous catheters should be replaced every 72-96 hours to reduce the risk of phlebitis, while in pediatric patients, catheters can remain in place until IV therapy is completed unless complications occur. 1, 2

Adult Peripheral IV Catheter Replacement Guidelines

• Replace short peripheral venous catheters in adults at least every 72-96 hours to reduce the risk of phlebitis 2
• If venous access sites are limited and no signs of complications are present, peripheral catheters may remain in place longer, but require close monitoring of both the patient and insertion site 2
• Clinically-indicated replacement (rather than routine replacement) has been shown to not increase phlebitis rates and may actually reduce phlebitis per 1000 catheter-days 3
• The probability of a standard open-system PIVC lasting 96 hours without complications is approximately 80%, while closed-system PIVCs may safely remain in place for up to 144 hours 4

Pediatric Peripheral IV Catheter Guidelines

• In pediatric patients, peripheral venous catheters should be left in place until IV therapy is completed, unless complications occur 2
• Complications requiring immediate removal include signs of phlebitis (warmth, tenderness, erythema, palpable venous cord), infection, infiltration, or catheter malfunction 2, 5
• Despite the longer dwell time permitted in pediatrics, daily evaluation of the catheter insertion site is still essential 5

Monitoring and Maintenance Requirements

• Evaluate catheter insertion sites daily by palpation through the dressing to detect tenderness, and by visual inspection if a transparent dressing is used 2, 1
• Remove peripheral venous catheters immediately if the patient develops signs of phlebitis, infection, or catheter malfunction 2, 5
• Clean injection ports with 70% alcohol or an iodophor before accessing the system 2, 1
• Cap all stopcocks when not in use to prevent contamination 2

Special Considerations

• Use a midline catheter or PICC when IV therapy is expected to exceed 6 days 2
• Catheters inserted under emergency conditions should be replaced within 48 hours 1
• Designate trained personnel for insertion and maintenance of intravascular catheters to minimize complications 2, 1
• Avoid steel needles for administration of fluids and medications that might cause tissue necrosis if extravasation occurs 5

Associated Component Replacement Schedule

• Replace IV tubing and add-on devices no more frequently than every 72-96 hours 1
• Replace tubing used for blood, blood products, or lipid emulsions within 24 hours of initiating the infusion 2, 1
• Replace needleless components at least as frequently as the administration set (every 72-96 hours) 1

Common Pitfalls to Avoid

• Do not delay removal of catheters when complications are suspected 5
• Do not routinely apply prophylactic topical antimicrobial or antiseptic ointment to insertion sites of peripheral venous catheters 2, 5
• Avoid placing new catheters in areas where previous complications have occurred 5
• When using clinically-indicated replacement strategies rather than routine replacement, ensure staff are trained to recognize early signs of complications 6