Table 1

Types and uses of current prevailing venous access devices

TYPE OF DEVICEWHEN TO USEWHEN TO AVOID
Peripheral devices
 •PIVFor short-term access (up to 96 hours)When access is needed for more than a few days
 •Midline catheterRarely used because of growing popularity of PICCsWhen access is needed for longer than 1 month or when vesicant medications are involved
Central devices
 •PICCFor medium-term access (up to 6 months) and especially for antibiotics, TPN, chemotherapy, transfusions, and frequent blood samplingWhen long-term (or permanent) access is required
Not recommended for dialysis (or predialysis) patients
 •Non-tunneled central catheterFor short-term access when PIV is not suitable, and especially for resuscitation and central venous pressure monitoringWhen access is required for more than a few days (use a tunneled catheter instead)
 •Tunneled central catheterFor frequent long-term access, and especially for TPN, transfusions, and frequent blood sampling Can be used when PICC line is contraindicated or not possibleWhen access of shorter duration is required (consider an implantable port if access is to be less frequent)
 •Implantable portFor infrequent access on a long-term basis or when lifestyle concerns make one of the other options less appealingWhen venous access is regularly required (frequent needle pokes would be uncomfortable for the patient)
  • PICC—peripherally inserted central catheter, PIV—peripheral intravenous, TPN—total parenteral nutrition.