Long length peripheral intravenous catheters
Topic Status Complete
Long length peripheral intravenous catheters for patients with difficult intravenous access
Outcome of the appraisal
Long peripheral intravenous catheters (LPCs) inserted catheter over needle should be routinely available as an alternative to short peripheral intravenous catheters (SPCs) for people with difficult intravenous access whose need for intravenous access is expected to last between four and 14 days. In other scenarios, LPCs show promise but the evidence is insufficient to support routine adoption.
Evidence suggests that LPCs may have an advantage over SPCs in terms of dwell time and catheter failure. Evidence also indicates that LPCs are at a disadvantage compared with midline catheters (MCs) in terms of dwell time and catheter failure, but there is less certainty in this finding.
Economic modelling suggests that LPCs inserted catheter over needle are cost effective for treatment durations of four to 14 days compared with SPCs. The cost effectiveness of LPCs compared with MCs or compared with SPCs over shorter treatment durations was unclear.
Why was this topic appraised?
Insertion of peripheral intravenous catheters (PIVCs) is the most common invasive procedure performed in acute healthcare, with approximately 90% of hospitalised patients requiring a PIVC. Difficult intravenous access (DIVA) can lead to multiple attempts at cannulation, causing pain and discomfort. The use of longer PIVCs, ranging from 6 to 15 cm in length (here, referred to as LPCs), may reduce the number of failed insertions and may have longer dwell times than shorter PIVCs.
This topic was suggested to HTW via the NHS Innovation Service.
Plain language summary
Intravenous (IV) therapy is a method for delivering medication, fluids and nutrients directly into a person’s blood stream. This method involves inserting plastic tubing into veins using a needle to pierce the skin and help guide the tubing. The tubing can be called a “catheter”, a “line” or “cannula”. The needle is removed once the tubing is placed. The other end of the tubing is connected to a large bag containing the medicine, fluids and/or nutrients. Peripheral IVs are ones that are put into veins on the lower part of the arm or the back of the hand.
Placing an IV catheter can be a painful experience. For some people, it may be harder to find a suitable vein or to get the tubing in place. This is called “difficult IV access”. It may be more difficult to place an IV catheter for people with certain characteristics, for example fragile veins. This can lead to multiple attempts to insert an IV by various healthcare professionals.
Long length IV catheters are IVs where the tubing is longer in length than usual. The extra length is proposed to help make insertion easier and may mean that the IV can stay in place for longer than usual. This would mean that patients with difficult IV access should experience fewer attempts to get an IV line placed and would need a replacement less frequently.
Health Technology Wales looked for evidence for long length peripheral IV catheters for patients with difficult IV access. Long peripheral intravenous catheters (LPCs) should be routinely available as an alternative to short peripheral intravenous catheters (SPCs) for people with difficult intravenous access whose need for intravenous access is expected to last between four and 14 days.
Topic Exploration Report
TER539 05.2024
Evidence Appraisal Report
EAR068 06.2025
Guidance
GUI068 06.2025
Health Technology Wales Partners
