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Minus Related Pages. Open All Close All What is a central venous catheter, and why is it used? What is a central venous catheter used for? Call anytime you think you may need emergency care. For example, call if:. Call your doctor now or seek immediate medical care if:.
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Top of the page. Overview What is a central venous catheter? What is a central venous catheter used for? Central venous catheters are used to: Give long-term medicine treatment for pain, infection, or cancer, or to supply nutrition. Give medicines that affect the heart, especially if a quick response to the medicine is wanted. Give large amounts of blood or fluid quickly. Take frequent blood samples without having to "stick" someone with a needle. To receive kidney dialysis if you have kidney failure.
What types of central venous catheters are there? Can complications result from the use of a central venous catheter? The catheter depth leading to optimum tip placement was noted. In males, catheter repositioning was required in 13 of 58 patients By cannulating the IJV through a central approach, the catheters can be fixed at a length of cm in males and cm in females in the right IJV and at a length of cm in males and cm in females in the left IJV in order to achieve correct positioning.
Central venous catheters CVC play a very important role in the management of critically ill patients in both ICUs and special wards. Apart from thrombosis and infections, their use is associated with many mechanical complications such as cardiac tamponade, perforation, pneumothorax and life-threatening arrhythmias.
For proper monitoring of central venous pressure and to avoid some of the life-threatening mechanical complications it is mandatory that the tip of the catheter lies in the correct position.
The correct position of the tip of CVC is considered to be in the superior vena cava SVC above the level of pericardial reflection.
In this study, we evaluated patients in whom CVCs were placed as part of the management. The position of the tip of the catheter and the rate of repositioning was observed. The position of the CVC tip was considered correct in the chest radiograph if it was just above the carina in right-sided catheters and just below the carina in left-sided catheters.
After approval by the institutional ethics committee, patients in the age group of years were enrolled in this prospective observational study. Patients with altered coagulation parameters, arrhythmias, pacemaker in situ , short neck, burn contractures of the neck and cervical spine injury were excluded from the study.
All catheters were placed by intensivists and trained doctors. The catheters were inserted to a length of cm in right-sided catheters and to a length of cm in left-sided catheters. A post procedure portable chest radiograph was performed in all the cases in supine position, for assessing the position of the tip of the catheter. CVC tip position was judged as correct if the tip was positioned just above the level of carina for right IJV catheters and just below the level of carina for left IJV catheters.
Catheters were repositioned after checking the tip position in the chest radiograph. The depth of insertion of the catheter after repositioning was noted and was confirmed by a repeat chest radiograph.
Of the patients evaluated, there were 71 male and 36 female patients. Total number of right IJV catheters was 83 Among the 71 male patients, 58 Among 36 females, 25 After observing the position of the catheter tip in post procedure chest radiograph, catheter repositioning was required in 15 of 71 males and 14 of 36 females. Repositioning was done in 13 of 58 After repositioning, chest radiograph was repeated to confirm the position of the tip and the catheter insertion depth was noted.
CVC insertion is associated with many mechanical complications with an incidence varying from 6. Vessel wall and cardiac perforation can occur immediately during the procedure either by guidewire, dilator or over insertion of the catheter. It can occur late as well, as either secondary to catheter advancement with head, arm and trunk movement or by tissue erosion caused by catheter tip abutting against vessel or cardiac wall, which is further aggravated by cardiac contractions.
Over insertion of the catheter can also lead to various arrhythmias including atrial and ventricular premature beats, ventricular tachycardia or fibrillation. These rhythm disturbances are usually resistant to drug suppression and require withdrawal of the catheter from the cardiac chambers.
Very rarely, a central line can cause a blood clot. Doctors review the risks with families before placing the central line. If your child has a central line, you can help care for it to prevent infection and keep it working well.
It's normal to feel a little bit nervous caring for the central line at first, but soon you'll feel more comfortable. You'll get supplies to use at home, and a visiting nurse may come to help you when you first get home. Tell your child's teachers, school nurse, counselor, and physical education teacher about the central line.
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