Central venous catheter

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Central Venous Catheter (CVC), also known as a central line, is a type of catheter placed into a large vein in the neck, chest, or groin. It is used to administer medication or fluids, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.[1]

Percutaneous central venous catheters
Central venous catheter
Blausen 0181 Catheter CentralVenousAccessDevice NonTunneled

Types of Central Venous Catheters

There are several types of central venous catheters, including:

  • Non-tunneled catheters: These are inserted directly into a central vein, often under emergency conditions.[2]
  • Tunneled catheters: These are inserted into a central vein, but the path from the skin to the vein traverses a longer subcutaneous tunnel. They are used for long-term therapy.[3]
  • Peripherally inserted central catheter (PICC): These are inserted through a peripheral vein and then advanced until the catheter's tip is in a large central vein.[4]
  • Implantable ports: These have a reservoir that is implanted under the skin. Medication is administered through the skin into the reservoir, which then drains into the central vein.[5]

Indications for Central Venous Catheter Use

Central venous catheters are typically used in clinical settings where:

  • Rapid fluid resuscitation is needed
  • Long-term intravenous medications are to be administered
  • The patient requires total parenteral nutrition
  • Frequent blood sampling is necessary
  • Hemodialysis is needed

Risks and Complications

While central venous catheters are a crucial tool in medical treatment, they come with risks, including infection, air embolism, and catheter thrombosis. Catheter placement may also cause pneumothorax, hemothorax, or injury to the blood vessels. Therefore, sterile technique is critical during catheter insertion to minimize infection risks, and healthcare providers must be adequately trained in central venous catheter placement to avoid procedural complications.[6]

Care and Maintenance

Proper care and maintenance of a central venous catheter is essential to prevent complications and prolong the catheter's usability. This includes regular cleaning of the catheter site, flushing the catheter to maintain patency, and monitoring for signs of infection or other complications. Dressing changes are typically performed using sterile technique, and the frequency depends on the type of dressing and the condition of the insertion site.[7]

Conclusion

Central venous catheters play a vital role in the management of many acute and chronic conditions. Despite the potential risks and complications, their benefits in providing efficient medication administration, fluid resuscitation, and blood sampling make them an indispensable tool in modern healthcare.

References

  1. Hamilton, H. Central Venous Access - Indications(link). NCBI Bookshelf.
  2. O'Grady, NP. Guidelines for the Prevention of Intravascular Catheter-Related Infections(link). CDC.
  3. O'Grady, NP. Guidelines for the Prevention of Intravascular Catheter-Related Infections(link). CDC.
  4. Chopra, V. Peripherally Inserted Central Catheter (PICC) Complications(link). NCBI Bookshelf.
  5. Debourdeau, P. 2013 ESC Guidelines on the management of venous thromboembolic diseases: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology(link). European Heart Journal.
  6. Preventing complications of central venous catheterization(link). New England Journal of Medicine.
  7. epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England(link). Journal of Hospital Infection.

See Also

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