Central Venous Catheters

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Topic Overview

What is a central venous catheter?

A central venous catheter, or vascular access device (VAD), is a long, thin, flexible tube used to give medications, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. The catheter is inserted through the skin into a vein often in the neck or chest. It is threaded through the vein until it reaches a large vein near the heart.

What is a central venous catheter used for?

Central venous catheters are used to:

• Give long-term medication treatment for pain, infection, cancer, or to supply nutrition. A central venous catheter can be left in place far longer than an intravenous catheter (IV), which gives medications into a vein near the skin surface.
• Give medications that affect the heart, especially if a quick response is wanted.
• Measure the blood pressure in the superior vena cava, which can help diagnose certain heart problems.

What types of central venous catheters are there?

There are several types of central venous catheters.

• A PICC (peripherally inserted central catheter) line is a central venous catheter inserted into a vein in the arm rather than a vein in the neck or chest.
• A tunneled catheter is surgically inserted into a vein in the neck or chest and passed under the skin. Only the end of the catheter is brought through the skin through which medications can be given. Passing the catheter under the skin helps keep it in place better, makes it less restrictive of activities, and makes it less visible.
• An implanted port is similar to a tunneled catheter but is left entirely under the skin. Medications are injected through the skin into the catheter. Some implanted ports contain a small reservoir that can be refilled in the same way. Once filled, the reservoir slowly releases the medication into the bloodstream. An implanted port is less obvious than a tunneled catheter and requires very little daily care. It has less impact on a person's activities than a PICC or tunneled catheter.

Can complications result from the use of a central venous catheter?

Possible complications from the use of a central venous catheter include:

• Bleeding, caused by inserting the catheter into the vein.
• Collapsed lung (pneumothorax). The risk of a collapsed lung varies with the skill of the person inserting the catheter and the site of placement. It is most likely during placement of a catheter in the chest, although the risk is still small.
• Infection, requiring treatment with antibiotics or removal of the catheter.
• Blockage or kinking of the catheter. Regular flushing of the catheter helps reduce blockage. A kinked catheter must be repositioned or replaced.
• Pain. You may experience pain at the point where the catheter enters your vein.
• Shifting of the catheter. A catheter that has moved out of place can sometimes be repositioned. If repositioning does not work, it must be replaced.

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Last updated:	October 24, 2005
Author:	Susan Van Houten, RN, BSN, MBA
Reviewed By:	Adam Husney, MD - Family Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer