An intravenous (IV) line is a small, flexible tube, or catheter, inserted directly into a vein to deliver fluids, medications, or blood products into the bloodstream. The duration an IV can safely remain in place varies widely, determined primarily by the type of device used, the patient’s underlying condition, and the nature of the treatment being administered. While some devices are designed only for a few days of use, others are intended to provide reliable access for several months or even years. The choice of device is a medical decision that balances the need for effective treatment with minimizing the risk of complications like infection and vein damage.
The Standard Lifespan of Peripheral IVs
The most common type of vascular access used in a hospital setting is the Peripheral Intravenous Catheter (PIVC), often simply called a peripheral IV. These devices are short, typically 3 to 6 centimeters in length, and are inserted into a smaller vein in the arm or hand. PIVCs are intended for short-term fluid and medication delivery, generally for a duration of less than one week.
For many years, the standard practice for PIVCs in adults involved routine replacement every 72 to 96 hours. This mandated replacement schedule was instituted to reduce the risk of phlebitis (inflammation of the vein) and local site infection. Research has demonstrated that the likelihood of phlebitis significantly increases when the catheter remains in place beyond 96 hours.
However, current clinical guidelines have evolved toward a “clinically indicated” replacement policy for adults. Under this approach, the IV is removed only when the patient completes therapy or if a complication develops, rather than on a fixed schedule. This change aims to reduce patient discomfort, vein trauma from unnecessary re-insertions, and healthcare costs.
Many institutions still maintain the 96-hour protocol as a safety measure. A healthcare provider may elect to keep a PIVC in place longer if the site shows no signs of complication. The Centers for Disease Control and Prevention (CDC) advises against replacing the catheter more frequently than every 72 to 96 hours. The device must be removed immediately if any adverse signs appear.
Devices Designed for Extended Access
When intravenous therapy is anticipated to last longer than a few days, different devices are used to provide more durable access. These devices are longer and are inserted into larger veins, allowing them to remain in place for weeks, months, or even years. They are categorized based on where the tip of the catheter ultimately rests in the body.
Midline Catheters
The Midline Catheter is longer (15 to 25 centimeters) and inserted into a peripheral vein in the upper arm. The tip of a midline rests in the large veins of the upper arm, usually below the armpit, but it does not extend into the central circulation. Midlines are intended for intermediate-term therapy, typically lasting between one to four weeks, and can sometimes remain in place for up to 30 days.
PICC Lines
For therapies requiring access for weeks to months, such as long courses of intravenous antibiotics or chemotherapy, a Peripherally Inserted Central Catheter (PICC line) is often chosen. A PICC line is inserted into a vein in the arm, but the catheter is threaded much further until its tip is positioned in a large vein near the heart. These central lines can remain functional for several months, sometimes up to a year. Their lifespan is determined by the completion of therapy or the development of a complication, not a routine schedule.
Implanted Ports
The longest-lasting option is the implanted port, a Central Venous Catheter (CVC) device designed for long-term access. The catheter remains under the skin, connecting a small reservoir (the port) that is implanted just beneath the skin of the chest. Because the device is sealed under the skin when not in use, the risk of infection is generally lower than with external lines. It requires less frequent maintenance, often only needing to be flushed monthly.
Signs That Require Immediate IV Removal
Certain signs and symptoms indicate a complication has occurred and require immediate removal of the catheter by a healthcare professional. One common issue is phlebitis, or vein inflammation, which presents with localized pain, redness, and warmth along the path of the vein. In some cases, the vein may feel hard or cord-like to the touch.
Another frequent complication is infiltration, which happens when fluid leaks out of the vein and into the surrounding tissue. This is observable as swelling, pallor (paleness), and a cool temperature of the skin around the insertion site. If the fluid infusing is a vesicant, meaning it is irritating to tissue, the complication is called extravasation, which can cause blistering, burning pain, and tissue damage.
Signs of a local infection at the site include the presence of pus or purulent drainage, increasing pain, and significant tenderness. Systemic signs of a spreading infection, such as fever or chills, also demand immediate removal and medical evaluation. A catheter that is blocked or occluded, causing the IV pump to alarm frequently or the fluid flow to slow, may also need to be removed if flushing attempts are unsuccessful.