A central venous catheter is a thin, long flexible tube that may be inserted into a large vein in the chest, groin, or neck. It can be used to administer medicines, nutrients, and fluids. Administration may take place over an extended period of time. Blood also may be drawn from this type of catheter.
There may be distinctive benefits of using a central venous catheter rather than an intravenous (IV) catheter. One benefit may be that these catheters are longer and generally are placed in larger veins, permitting larger liquid distribution. Additionally, they can remain in the body for a longer amount of time. The time periods may extend to several weeks or more.
Central venous catheter placement may be necessary for many reasons. Some of these reasons include administering medications such as chemotherapy, receiving dialysis, and for long term parenteral nutrition or pain treatment. Other reasons can include frequent blood draws, to quickly receive medicines that affect the heart, for long-term antibiotics, and for any other reason of which frequent intravenous access may be necessary.
Depending on the type of catheter used, it may be inserted at the bedside or in an operating room. Local anesthetics generally are applied to the skin before the insertion takes place. Some of the different types of a central venous catheter include a peripherally inserted central catheter (PICC) line, a tunneled catheter, and an implanted port. Different catheters typically have different insertion locations.
PICC lines commonly are inserted into a vein in the arm rather than in the chest, neck, or groin. A tunneled central venous catheter generally is surgically inserted. It may be inserted into a vein in the chest or neck. Medicine can be given through the one end which is tunneled through the skin. This could help to better keep the catheter in place.
Implanted ports generally are left completely under the skin. Medications can be given through the skin into the catheter. There are some implanted ports that may be refilled through a small reservoir. This type of catheter may typically be easier to maintain on a daily basis. It usually requires minimum daily care and may be less obvious than a tunneled catheter or PICC line.
The insertion site for a catheter may be found using an ultrasound or X-ray. If the catheter is placed into the chest, it can be inserted through the subclavian vein. An insertion in the neck may be placed into the internal jugular vein. Additionally, catheters inserted through the groin may be placed through the femoral vein.
Complications can arise from a central venous catheter placement. One of the most common problems may be infections. If an infection is suspected, blood may be taken from the catheter and a vein other than the insertion site. Antibiotics generally are used to treat infections. The catheter may be removed if needed.
Other possible problems may include pneumothorax, which is a collapsed lung. An additional complication can arise from shifting of the catheter. If the catheter happens to move out of place, it may need to be repositioned. Bleeding from the insertion site may be an additional complication.
Signs of a problem may be similar in different types of catheters. Other problematic symptoms may include a fever, pain, redness, or tenderness at the insertion site, among other problems. If an infection or other catheter problem is suspected, a doctor typically should be called immediately.