Understanding How Long Can an IV Line Be Left In?

October 1, 2025 •

4 min read

The Centers for Disease Control and Prevention (CDC) guidelines for peripheral IV catheters have evolved from routine replacement to a clinically-indicated approach for adults, significantly influencing how long can an IV line be left in. However, the duration varies greatly depending on the specific type of intravenous (IV) catheter used for treatment.

Quick Summary

The dwell time for an IV line depends on the catheter type, ranging from days for a peripheral IV to weeks or months for central lines. Healthcare providers base catheter replacement on regular site assessment rather than a fixed schedule. Proper monitoring is essential to detect signs of complications.

Key Points

Dwell Time Varies: The safe duration depends on the catheter type; peripheral IVs are for short-term use while central catheters are for long-term therapy.
Clinically-Indicated Replacement: For adult peripheral IVs, the CDC recommends replacement based on clinical need rather than a rigid 72-96 hour schedule.
Monitor for Complications: All IV sites require regular inspection for signs of phlebitis, infiltration, or infection, including swelling, redness, pain, and warmth.
Strict Aseptic Technique is Essential: Proper hand hygiene and sterile technique must be followed to prevent infections, especially for central lines.
Report Problems Immediately: Any signs of an issue, such as pain, swelling, or fever, should be reported to a healthcare provider promptly to prevent complications.

IV Catheter Dwell Time: A Guide to the Different Types

Intravenous (IV) therapy is a common medical procedure, but the question of how long a line can stay in place has a nuanced answer. The duration, or 'dwell time,' is not a one-size-fits-all rule but depends on the type of catheter and the patient's individual clinical needs. Advancements in medical practice and research have shifted standard care, emphasizing patient comfort and safety over rigid timeframes.

Peripheral IV Catheters (PIVs)

PIVs are the most common type of IV line, used for short-term fluid administration, medication, and blood transfusions. They are inserted into a smaller peripheral vein, typically in the hand or arm.

Historically, guidelines recommended routine replacement of PIVs every 72 to 96 hours to prevent infection. However, recent clinical trials and updated recommendations from the CDC suggest that for adults, replacing PIVs only when there is a clinical indication (such as signs of inflammation, infection, or malfunction) is a safe and effective alternative. This 'clinically-indicated' approach reduces discomfort for the patient, saves costs, and decreases staff workload. For children, PIV replacement is recommended only when clinically indicated.

Midline Catheters

Midline catheters are longer than PIVs and inserted into a larger peripheral arm vein, with the tip below the axilla but not in a central vein. They are used for medium-term therapy, lasting typically one to four weeks. Midlines are suitable for patients requiring IV therapy longer than six days and should be replaced only when clinically indicated.

Peripherally Inserted Central Catheters (PICCs)

A PICC line is inserted into a peripheral arm vein and advanced to a large central vein near the heart. They are used for long-term administration of medications or nutrition that are irritating to smaller veins. PICC lines can remain in place for weeks to months if they function correctly and show no signs of infection. Strict sterile technique is crucial during insertion and maintenance to prevent serious bloodstream infections.

Other Central Venous Catheters (CVCs)

For very long-term needs, other types of CVCs are used, such as tunneled catheters and implantable ports. Tunneled catheters are inserted into a central vein and guided under the skin, designed to remain for weeks to months. Implantable ports are placed entirely under the skin and can remain for years, with medication delivered through a special needle.

Why Routine Replacement is No Longer Standard for All IVs

The change from mandatory routine replacement for adult PIVs was based on evidence showing no significant reduction in complications like phlebitis or infection compared to replacing them as needed. This approach is better for patients due to fewer needle sticks and also more cost-effective.

Monitoring and Maintenance

Regardless of the IV type, vigilant monitoring is essential. Healthcare providers and patients should watch for complications.

Key aspects of IV care and monitoring include:

Regular Site Assessment: Daily checks for tenderness, redness, swelling, or warmth are important.
Aseptic Technique: Maintaining proper hand hygiene and aseptic technique during all IV procedures is critical for preventing infection.
Dressing Management: Dressings must be kept clean, dry, and intact, and replaced if soiled or loose.
Patency Checks: Regular flushing ensures the line remains open and functional.

Risks of Leaving an IV in Too Long

Leaving an IV line in longer than appropriate or neglecting monitoring can lead to serious health issues:

Phlebitis: Inflammation of the vein causing pain, warmth, redness, and swelling.
Infiltration or Extravasation: Fluid leaking into surrounding tissue, causing swelling and discomfort. Extravasation is when the leaked fluid is damaging to tissue.
Infection: Local site infection or a bloodstream infection, which can lead to sepsis.
Occlusion: The catheter can be blocked by a blood clot or debris.

Comparison of IV Line Types


IV Type	Typical Dwell Time	Indications for Use
Short Peripheral IV (PIV)	Clinically indicated, but often <96 hours for adults.	Short-term fluid and medication administration.
Midline Catheter	1 to 4 weeks.	Moderate-term IV therapy, especially if PIV access is difficult.
PICC Line	Weeks to months.	Long-term antibiotic therapy, chemotherapy, and TPN.
Tunneled CVC	Weeks to months, sometimes years.	Very long-term access, hemodialysis.
Implantable Port	Months to years.	Long-term chemotherapy, intermittent access.

Conclusion: Choosing the Right IV and Careful Monitoring

The safe duration for an IV line is determined by the catheter type and the patient's clinical needs. While routine replacement of adult peripheral IVs is no longer standard, monitoring for complications remains vital. Midline catheters and central lines require meticulous care to prevent serious issues. Patients and caregivers should understand the IV type and proper care, and report any signs of a problem to a healthcare provider. For more details, the CDC offers guidelines on preventing intravascular catheter-related infections {Link: CDC https://www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infection/prevention-strategies.html}.

Frequently Asked Questions

For adults, peripheral IVs are now typically replaced only when there is a clinical indication like pain, swelling, or malfunction. While some older guidelines suggested 72-96 hours, recent evidence shows that a clinically-indicated approach is safe and effective.

A PICC line can stay in place for an extended period, from weeks to months, as long as it remains functional and shows no signs of complications like infection.

Signs that an IV site may have a problem include pain, swelling, warmth, redness, a hard venous cord, or pus. For central lines, fever and chills can indicate a systemic infection.

Yes, infections can occur if bacteria from the skin or equipment enter the bloodstream. Proper aseptic technique during insertion and daily site monitoring greatly reduce this risk. If left unchecked, it can lead to a serious bloodstream infection.

Midline catheters are used for medium-term therapy, lasting 1 to 4 weeks. PICC lines are used for longer-term therapy, lasting weeks to months, because their tip sits in a larger, central vein.

If your IV site becomes painful, red, or swollen, you should contact a healthcare provider immediately. These are signs of phlebitis or infiltration, and the line may need to be removed.

Patients should never remove their own IV unless they have received explicit instructions from their doctor. Attempting to remove it incorrectly can cause bleeding or other complications. The exception may be a specific type of simple peripheral IV in a non-medicated setting, but a healthcare professional should always be consulted.