What Are Central Venous Catheters?

While treating you for certain medical conditions, your physician may choose to supply you with a central venous catheter (CVC). It is also referred to as a central line. It boasts the ability to smoothly deliver medication, nutrients, blood, and fluids and allows for quick sampling of blood to perform various medical tests.

How Does It Work?

Despite an intimidating name, a central venous catheter is simply a flexible, thin tube that is inserted into a large vein somewhere on the arm, chest, or groin. It is expertly threaded (guided) through the vein until it reaches the superior vena cava, a large vein above the right side of the heart.

Unlike a standard intravenous line (IV) that supplies medication and fluids to a vein below the skin's surface, a CVC can remain in place for a longer period, perhaps weeks or months. Thankfully, a central line will prevent wear on your vein by removing the need for multiple needle sticks normally required for injections or blood sampling.

Are There Different Types?

There are multiple kinds of CVCs, and your physician will decide which type is best for your particular condition.

PICC Line (Peripherally Inserted Central Catheter)

One end of this catheter type is inserted into a vein of the arm and then threaded to the superior vena cava that drains into the heart. The other end will remain outside of the arm above the elbow, and it may have one or two small tubes known as lumens – locations for medication administration or blood sampling.

Implanted Tunneled Port

Also known as simply a "port", this type of CVC also reaches the superior vena cava, but the entire line remains under the skin. The catheter is connected to a port or a plastic disc, which can be felt superficially under the skin, and your physician will administer treatment by inserting a needle through the skin and into the disc.

Ports do require minor, short surgery but they stand out in their ability to allow more freedom in daily activities than a PICC line.

Tunneled CVC

This kind of line requires your physician to make two small incisions, place the catheter into the vein, and guide one end toward the heart. The opposite end is placed within the tunnel superficially underneath the skin between both incisions and will terminate with one or more lumens.

What Conditions Might Require a Central Venous Catheter?

Many medical issues may benefit from this type of catheter, including:

Kidney dialysis several times a week
Chemotherapy cancer treatment
Long-term antibiotic treatment
Bowel problems requiring supplemental nutrition
Need for frequent blood tests
Requirement for self-treatment at home

Can Complications Arise?

As with any procedure, the placement of a central line does carry some risk of complications. Examples include:

Mechanical

Arterial puncture
Hematoma (blood collecting outside a vessel)
Pneumothorax (collapsed lung)

Infectious

Infections may develop due to pathogens collecting near locations such as:

Exit site
External catheter surface
Catheter hub
Internal catheter surface

Thrombotic

Placement of a CVC may result in catheter-related thrombosis, in which a blood clot has formed within the vein.

What Can Be Done to Avoid Catheter-Related Infections?

Central line-associated bloodstream infection (CLABSI) is a serious condition resulting from microbes finding their way into the bloodstream via the catheter.

You can help ensure healthcare workers are careful to take precautions that include:

Thorough hand hygiene
Sterile barrier precautions at insertion
Choosing a subclavian (below the collarbone) venous insertion site whenever possible
Disinfecting skin with a 2% chlorhexidine alcoholic preparation
Use of dressings saturated with chlorhexidine
Quick replacement of detached or moistened dressings

You can help prevent infection yourself by attempting to:

Discover the hospital's CLABSI rate
Speak up to remind healthcare staff to follow effective infection prevention practices
Alert a staff member if a bandage comes loose or the surrounding area becomes damp or dirty
Keep the central line and insertion area dry
Notify a healthcare worker if the CVC's surrounding area becomes sore or red
Let a staff member know if you develop a fever or chills
Prevent yourself and visitors from touching the catheter or its tubing

When properly maintained, a central venous catheter can be an effective short-term tool for you and healthcare workers as you undergo treatment for certain medical conditions.