Central venous catheter
Updates to Article Attributes
Central venous catheters (CVC), also known as central venous lines (CVL), refer to a wide range of catheters that are inserted, so that their distal tips lie in a central vein. Central venous access devices can broadly be divided into four categories. They may be inserted by medical, surgical, anaesthetic/ITU, or radiology specialists.
Classification
- peripherally inserted central catheters (PICC)
- non-tunnelled CVCs
- e.g. used in ICU or ED for emergent or short-term (<7-10 days) access
- e.g. Vascath used for haemodialysis, apheresis, stem cell collection, etc
- tunnelled CVCs
- e.g. Hickman catheters, Groshong catheter, Broviac line, Permcath
-
implantable ports
- e.g. Port-a-Cath, Infus-a-Port
- may be located in the chest or arm (brachial)
- may be single or dual lumen
Site
Central venous catheters can be inserted into a variety of veins, most commonly including:
- internal jugular vein (see: jugular venous catheters)
- subclavian vein
- femoral vein (typically only short-term access)
- brachial, basilic or cephalic veins (for PICCs and implantable ports)
Placement
Policy varies by institution but tip placement for neck/thoracic/upper limb CVCs in the superior vena cava or at the cavoatrial junction is generally acceptable. There is a limited differential of left paramediastinal catheter positions.
Ultrasound-guided CVL insertion proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement.
Complications
- pneumothorax
- haemothorax
- infusothorax
- arrhythmia
- infection
- mediastinal haematoma
- arterial placement
- perforation of vein needing a stent
- pinch off syndrome
- retained guidewire
- guidewire shearing and fragment embolisation
- sheared fragment of catheter
- malposition of port and or tip
- azygos termination
- retained hub
- downhill esophageal varices
-<p><strong>Central venous catheters</strong> (<strong>CVC</strong>), also known as <strong>central venous</strong> <strong>lines</strong> (<strong>CVL</strong>), refer to a wide range of catheters that are inserted, so that their distal tips lie in a <a href="/articles/central-vein">central vein</a>. Central venous access devices can broadly be divided into four categories. They may be inserted by medical, surgical, anaesthetic/ITU, or radiology specialists.</p><h4>Classification</h4><ul>- +<p><strong>Central venous catheters</strong> (<strong>CVC</strong>), also known as <strong>central venous</strong> <strong>lines</strong> (<strong>CVL</strong>), refer to a wide range of catheters that are inserted so that their distal tips lie in a <a href="/articles/central-vein">central vein</a>. Central venous access devices can broadly be divided into four categories. They may be inserted by medical, surgical, anaesthetic/ITU, or radiology specialists.</p><h4>Classification</h4><ul>
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