Central venous catheter
Disclosures
- updated 17 Sep 2022:
Nothing to disclose
Updates to Article Attributes
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was changed:
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/ICU, or radiology specialists.
Classification
-
non-tunnelled CVCs
e.g. used in ICU or ED for emergent or short-term (<7-10 days) access
e.g. Vascath is used for haemodialysis, aphaeresis, stem cell collection, etc.
-
tunnelled CVCs
e.g. Hickman catheters, Groshong catheter, Broviac line, Permcath
-
e.g. Port-a-Cath, Infus-a-Port
may be located in the chest or arm (brachial)
may be a single or dual lumen
Site
Central venous catheters can be inserted into a variety of veins, most commonly including:
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 is proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement.
Complications
arrhythmia
infection
perforation of vein needing a stent
-<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/ICU, or radiology specialists.</p><h4>Classification</h4><ul>-<li><a href="/articles/peripherally-inserted-central-catheter-1">peripherally inserted central catheters (PICC)</a></li>-<li>non-tunnelled CVCs<ul>-<li>e.g. used in ICU or ED for emergent or short-term (<7-10 days) access</li>-<li>e.g. Vascath used for haemodialysis, aphaeresis, stem cell collection, etc.</li>-</ul>-</li>-<li>tunnelled CVCs<ul><li>e.g. <a href="/articles/hickman-catheter">Hickman catheters</a>, <a href="/articles/groshong-catheter">Groshong catheter</a>, Broviac line, Permcath</li></ul>-</li>-<li>-<a href="/articles/implantable-port">implantable ports</a><ul>-<li>e.g. Port-a-Cath, Infus-a-Port</li>-<li>may be located in the chest or arm (brachial)</li>-<li>may be single or dual lumen</li>-</ul>-</li>-</ul><h4>Site</h4><p>Central venous catheters can be inserted into a variety of veins, most commonly including:</p><ul>-<li>-<a href="/articles/internal-jugular-vein">internal jugular vein</a> (see: <a href="/articles/jugular-venous-catheters">jugular venous catheters</a>)</li>-<li><a href="/articles/subclavian-vein">subclavian vein</a></li>-<li>-<a href="/articles/femoral-vein">femoral vein</a> (typically only short-term access)</li>-<li>-<a href="/articles/brachial-vein">brachial</a>, <a href="/articles/basilic-vein-1">basilic</a> or <a href="/articles/cephalic-vein-1">cephalic veins</a> (for PICCs and implantable ports)</li>-</ul><h4>Placement</h4><p>Policy varies by institution but tip placement for neck/thoracic/upper limb CVCs in the <a href="/articles/superior-vena-cava">superior vena cava</a> or at the <a href="/articles/superior-cavoatrial-junction-1">cavoatrial junction</a> is generally acceptable. There is a limited <a href="/articles/left-paramediastinal-catheter-position-differential">differential of left paramediastinal catheter positions</a>.</p><p>Ultrasound-guided CVL insertion is proposed to reduce the number of complications and to increase the safety and quality of <a href="/articles/central-venous-catheter">central venous catheter (CVC)</a> placement.</p><h4>Complications </h4><ul>-<li><a href="/articles/pneumothorax">pneumothorax</a></li>-<li><a href="/articles/haemothorax">haemothorax</a></li>-<li><a href="/articles/infusothorax">infusothorax</a></li>-<li>arrhythmia</li>-<li>infection</li>-<li><a href="/articles/mediastinal-haematoma">mediastinal haematoma</a></li>-<li><a href="/articles/arterial-placement">arterial placement</a></li>-<li>perforation of vein needing a stent</li>-<li><a href="/articles/pinch-off-syndrome">pinch off syndrome</a></li>-<li><a href="/articles/retained-guidewire">retained guidewire</a></li>-<li><a href="/articles/guidewire-shearing-and-fragment-embolisation">guidewire shearing and fragment embolisation</a></li>-<li><a href="/articles/sheared-fragment-of-catheter">sheared fragment of catheter</a></li>-<li>-<a href="/articles/malposition">malposition</a><a href="/articles/malposition-of-port-and-tip"> of port and or tip</a>-</li>-<li><a href="/articles/azygos-termination">azygos termination</a></li>-<li><a href="/articles/retained-hub">retained hub</a></li>-<li><a href="/articles/downhill-oesophageal-varix">downhill oesophageal varices</a></li>- +<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/ICU, or radiology specialists.</p><h4>Classification</h4><ul>
- +<li><p><a href="/articles/peripherally-inserted-central-catheter-1">peripherally inserted central catheters (PICC)</a></p></li>
- +<li>
- +<p>non-tunnelled CVCs</p>
- +<ul>
- +<li><p>e.g. used in ICU or ED for emergent or short-term (<7-10 days) access</p></li>
- +<li><p>e.g. Vascath is used for haemodialysis, aphaeresis, stem cell collection, etc.</p></li>
- +</ul>
- +</li>
- +<li>
- +<p>tunnelled CVCs</p>
- +<ul><li><p>e.g. <a href="/articles/hickman-catheter">Hickman catheters</a>, <a href="/articles/groshong-catheter">Groshong catheter</a>, Broviac line, Permcath</p></li></ul>
- +</li>
- +<li>
- +<p><a href="/articles/implantable-port">implantable ports</a></p>
- +<ul>
- +<li><p>e.g. Port-a-Cath, Infus-a-Port</p></li>
- +<li><p>may be located in the chest or arm (brachial)</p></li>
- +<li><p>may be a single or dual lumen</p></li>
- +</ul>
- +</li>
- +</ul><h4>Site</h4><p>Central venous catheters can be inserted into a variety of veins, most commonly including:</p><ul>
- +<li><p><a href="/articles/internal-jugular-vein">internal jugular vein</a> (see: <a href="/articles/jugular-venous-catheters">jugular venous catheters</a>)</p></li>
- +<li><p><a href="/articles/subclavian-vein">subclavian vein</a></p></li>
- +<li><p><a href="/articles/femoral-vein">femoral vein</a> (typically only short-term access)</p></li>
- +<li><p><a href="/articles/brachial-vein">brachial</a>, <a href="/articles/basilic-vein-1">basilic</a> or <a href="/articles/cephalic-vein-1">cephalic veins</a> (for PICCs and implantable ports)</p></li>
- +</ul><h4>Placement</h4><p>Policy varies by institution but tip placement for neck/thoracic/upper limb CVCs in the <a href="/articles/superior-vena-cava">superior vena cava</a> or at the <a href="/articles/superior-cavoatrial-junction-1">cavoatrial junction</a> is generally acceptable. There is a limited <a href="/articles/left-paramediastinal-catheter-position-differential">differential of left paramediastinal catheter positions</a>.</p><p>Ultrasound-guided CVL insertion is proposed to reduce the number of complications and to increase the safety and quality of <a href="/articles/central-venous-catheter">central venous catheter (CVC)</a> placement.</p><h4>Complications </h4><ul>
- +<li><p><a href="/articles/pneumothorax">pneumothorax</a></p></li>
- +<li><p><a href="/articles/haemothorax">haemothorax</a></p></li>
- +<li><p><a href="/articles/infusothorax">infusothorax</a></p></li>
- +<li><p>arrhythmia</p></li>
- +<li><p>infection</p></li>
- +<li><p><a href="/articles/mediastinal-haematoma">mediastinal haematoma</a></p></li>
- +<li><p><a href="/articles/arterial-placement">arterial placement</a></p></li>
- +<li><p>perforation of vein needing a stent</p></li>
- +<li><p><a href="/articles/pinch-off-syndrome">pinch off syndrome</a></p></li>
- +<li><p><a href="/articles/retained-guidewire">retained guidewire</a></p></li>
- +<li><p><a href="/articles/guidewire-shearing-and-fragment-embolisation">guidewire shearing and fragment embolisation</a></p></li>
- +<li><p><a href="/articles/sheared-fragment-of-catheter">sheared fragment of catheter</a></p></li>
- +<li><p><a href="/articles/malposition">malposition</a><a href="/articles/malposition-of-port-and-tip"> of port and or tip</a></p></li>
- +<li><p><a href="/articles/azygos-termination">azygos termination</a></p></li>
- +<li><p><a href="/articles/retained-hub">retained hub</a></p></li>
- +<li><p><a href="/articles/downhill-oesophageal-varix">downhill oesophageal varices</a></p></li>
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