How long can a Peripherally Inserted Central Catheter (PICC) line stay in place?

How Long Can a PICC Line Stay In?

A PICC line does not have an arbitrary time limit and can remain in place as long as it is functioning properly without complications, though it is most appropriate for intermediate-term use ranging from weeks to approximately 3 months. 1

Duration Guidelines by Clinical Context

General Medical Patients

• PICCs are appropriate when the anticipated duration of intravenous therapy is 15 or more days 2, 1
• For shorter durations (6-14 days), midline catheters are preferred over PICCs 2
• The duration is not limited by arbitrary time constraints but rather by functionality and absence of complications 1

Medium-Term Use (Up to 3 Months)

• PICCs are classified as medium-term devices suitable for use up to 3 months in both hospitalized and non-hospitalized patients 2
• This timeframe applies to patients receiving parenteral nutrition in hospitals, day hospitals, hospices, or at home 2

Long-Term Use (Beyond 3 Months)

• For anticipated durations exceeding 3 months, tunneled catheters or implantable ports are more appropriate than PICCs 2
• PICCs are not recommended for expected long-term home parenteral nutrition due to higher thrombosis risk and difficulties with self-administration 2

Special Population Considerations

Cancer Patients

• For non-irritant/non-vesicant chemotherapy, PICCs are appropriate only if treatment duration is 3 months or less 2
• For irritant or vesicant chemotherapy, PICCs are appropriate at all time intervals 2
• In hospitalized cancer patients requiring frequent phlebotomy or difficult access, PICCs are appropriate only for 15 or more days of use 2

Critically Ill Patients

• In hemodynamically stable critically ill patients, PICCs are appropriate for 15 or more days of peripherally compatible infusates 2
• For shorter durations (6-14 days), central venous catheters are preferred 2

Patients Requiring Lifelong Access

• In patients with conditions like short-gut syndrome or cystic fibrosis who are infrequently hospitalized, PICCs are appropriate for 15 or more days 2
• For frequently hospitalized patients in this category, tunneled catheters are preferred over PICCs when use exceeding 15 days is expected 2

Key Factors Determining Duration

Removal Indications

• Remove PICCs when they have not been used for any clinical purpose for 48 hours or longer 1
• Remove when there are signs of complications including infection, thrombosis, or mechanical failure 1
• Regular assessment for complications is more important than routine replacement based on time 1

Common Pitfalls

• The median duration in oncology-hematology patients is approximately 26 days, with mechanical complications (obstruction 13.5%, accidental removal 9.6%) being more common than infectious complications (3.8%) 3
• Exit site location at the antecubital fossa or midarm effectively disables one hand, making self-care difficult for home therapy 2
• Thrombosis risk is a particular concern in cancer patients, making PICCs less suitable for prolonged use in this population 2

Practical Duration Ranges

While PICCs can theoretically remain in place indefinitely if functioning well, the evidence supports these practical timeframes:

• Optimal use: 15 days to 3 months 2, 1
• Acceptable short-term use: 6-14 days (though midlines may be preferable) 2
• Beyond 3 months: Consider transitioning to tunneled catheter or port 2