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Updated: May 11, 2026
09:57
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Clinically-indicated replacement versus routine replacement of peripheral venous catheters
Joan Webster1, Sonya Osborne, Claire M Rickard
1Centre for Clinical Nursing, Royal Brisbane andWomen’s Hospital, Brisbane, Australia. joan_webster@health.qld.gov.au.
The Cochrane Database of Systematic Reviews
|May 2, 2013
Summary
Routine replacement of peripheral intravenous catheters every 72-96 hours is not supported by evidence. Changing catheters only when clinically indicated reduces costs and patient discomfort without increasing infection or phlebitis risks.
Area of Science:
- Infectious Diseases
- Clinical Practice Guidelines
- Health Economics
Background:
- Current US CDC guidelines recommend routine peripheral intravenous (IV) catheter replacement every 72-96 hours to prevent complications.
- Routine replacement aims to reduce phlebitis and bloodstream infections but may cause unnecessary patient discomfort and incur significant costs.
- This review is an update of previous research on peripheral IV catheter management strategies.
Purpose of the Study:
- To compare the clinical outcomes and costs of removing peripheral IV catheters based on clinical indication versus routine scheduled replacement.
- To evaluate the impact of different catheter removal strategies on patient safety and healthcare resource utilization.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing clinically indicated removal versus routine replacement of peripheral IV catheters.
- Searches were conducted in the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Register, CENTRAL, MEDLINE, and clinical trials registries.
- Data on catheter-related bloodstream infection (CRBSI), phlebitis, all-cause bloodstream infection, and costs were extracted and analyzed.
Main Results:
- Seven RCTs involving 4895 patients were included. No significant differences in CRBSI rates (RR 0.61, 95% CI 0.08-4.68) or phlebitis rates (RR 1.14, 95% CI 0.93-1.39) were observed between groups.
- Analysis by device days also showed no significant difference between clinically indicated and routine replacement.
- Clinically indicated removal resulted in significant cost savings of approximately AUD 7.00 per patient (MD -6.96, 95% CI -9.05 to -4.86).
Conclusions:
- There is no evidence to support the routine replacement of peripheral IV catheters every 72-96 hours.
- Healthcare organizations should consider adopting policies for clinically indicated catheter removal to reduce costs and patient discomfort.
- Minimizing complications requires regular inspection of the insertion site for signs of inflammation, infiltration, or blockage.
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