What is the safe duration for maintaining Intravenous (IV) access?

From the Guidelines

Intravenous (IV) access should not be maintained for more than 96 hours.

Safe Duration for Maintaining IV Access

• The Centers for Disease Control and Prevention (CDC) recommends replacing short, peripheral venous catheters at least every 72-96 hours to reduce the risk of phlebitis 1.
• If the duration of IV therapy will likely exceed 6 days, a midline catheter or Peripherally Inserted Central Catheter (PICC) should be used 1.
• Midline catheters can be used for up to 4 weeks, but are not preferred for durations beyond this period 1.
• Peripheral venous catheters can be left in place for longer periods if sites for venous access are limited and no evidence of phlebitis or infection is present, but the patient and insertion sites should be closely monitored 1.
• The use of tunneled catheters and implanted ports is only appropriate if the proposed duration of infusion is 31 or more days 1.

From the Research

Safe Duration for Maintaining Intravenous (IV) Access

The safe duration for maintaining IV access can vary depending on several factors, including the type of catheter used, the location of the catheter, and the patient's individual characteristics.

• According to 2, the risk of complications increases when IV access is kept beyond 3 days, with more than 50% of patients experiencing local complications at the IV access site.
• A study by 3 found that the average catheter duration for long peripheral catheters ranged from 4 to 14.7 days, with a median duration of 1.1 to 9 days.
• For central venous catheters (CVCs), the duration of use can be longer, but the risk of infection and other complications also increases, especially for long-term parenteral nutrition beyond 6 months 4.
• The use of antimicrobial lock therapies and careful placement and positioning of the catheter tip under sonographic guidance can help minimize complications and extend the safe duration of IV access 4.

Factors Affecting Safe Duration

Several factors can affect the safe duration of IV access, including:

• Patient characteristics, such as age, weight, and medical history 2
• Type and size of catheter used 2, 3
• Location of catheter placement 2
• Level of care and expertise of healthcare personnel 2
• Use of ultrasound guidance and antimicrobial lock therapies 4, 3

Best Practices for IV Access Management

Best practices for IV access management include:

• Careful selection of catheter type and size based on patient characteristics and estimated duration of need 4
• Use of skin barriers and larger diameters for long-term parenteral nutrition beyond 6 months 4
• Regular dressing changes and monitoring for signs of complications 2
• Minimizing the number of lumens to reduce the risk of infection 4
• Considering the use of long peripheral catheters for multi-day intravenous therapy 3