Stop Changing IV Cannulas “Just Because”: What the Latest Evidence Says

Study Overview

Many hospitals still replace peripheral venous catheters (PVCs / IV cannulas) routinely every 72-96 hours. Another approach is clinically indicated removal—leaving the cannula in place unless there’s a reason to remove it (e.g., therapy finished, pain, leaking, blockage, suspected infection). This 2026 Cochrane review pooled evidence from 14 randomised trials including 11,428 participants to compare these approaches.

Key Findings

• Serious infections were rare and similar across both approaches, with no clear difference in bloodstream infection outcomes or mortality.
• Thrombophlebitis was similar, with no convincing difference between strategies.
• Routine replacement may slightly reduce infiltration and occlusion, but the differences were small and uncertain.
• Clinically indicated removal reduced costs and used fewer cannulas per patient, meaning fewer unnecessary re-sites for many patients.

Implications

Overall, the evidence supports that clinically indicated removal is a safe and practical default in many settings—especially when teams have strong cannula assessment habits. The most important factors for success are consistent site checks, clear removal criteria, and removing cannulas promptly when they are no longer needed or show early signs of failure.

Read More:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007798.pub6/full 

Authors: Karina R Charles; Jessica A Schults; Nicole Marsh; Sonya R Osborne; Sharon Rees; Gabor Mihala; Sarah Smith; Claire M Rickard