What is a central venous catheter?
A central venous catheter, also called a central line or CVC, is a device that helps you receive treatments for various medical conditions. It’s made of a long, thin, flexible tube that enters your body through a vein. The tube travels through one or more veins until the tip reaches the large vein that empties into your heart (vena cava).
Thus, your CVC’s tip is located in your vena cava. The other end is located just above or below your skin somewhere on your chest, usually on your right side. If it’s on the outer surface of your skin, it’s called a hub. You can see and feel the hub since it’s outside your body. If the other end is underneath your skin, it’s called a portal or reservoir. You can see and feel a small (quarter-sized) bump below your skin, but it’s not as noticeable. The hub or reservoir is the access point for your treatment.
A CVC allows your provider to access your bloodstream easily, reducing the need for many needle sticks into your vein. So, a CVC is ideal for people who need long-term medications, fluids, blood draws or blood transfusions. People who need emergency care or short-term treatments also benefit from CVCs.
Central venous catheter vs. intravenous catheters (peripheral IVs)
Central venous catheters and intravenous catheters (also called peripheral IVs) both provide treatments and both devices enter your body through a vein. But they have three main differences:
- Where they enter your body.
- How big they are.
- How long they can stay in your body.
Central lines and peripheral IVs enter your body through different veins. Central lines enter a large vein in your chest, neck, arm or groin. It’s usually a deep vein that’s not close to the surface of your skin. Peripheral IVs enter a vein close to your skin’s surface in your hand or arm.
When it comes to size, central lines are longer and have a bigger tube. That’s because they need to travel farther to reach their destination. Some central lines have more than one tube. These are called double or triple lumen catheters. They can accommodate different types of medicine in complex situations.
When it comes to duration, central lines can stay in your body longer than peripheral IVs. You usually need to change peripheral IVs every few days. But some types of central lines can stay in for weeks or many months.
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Who needs a central line?
Central lines help people in many different medical situations, including people who need:
- Blood or platelet transfusions.
- Chemotherapy.
- Fluids or blood in an emergency situation (like hypovolemic shock).
- Frequent blood draws.
- Hemodialysis.
- Long-term antibiotics.
- Nutrients delivered directly into their blood (if their digestive system isn’t working properly).
- The ability to receive medications at home.
- Vena cava filter placement.
Providers also use CVCs during some medical tests.
What are the different central venous catheter types?
Central venous catheters come in many forms. These include:
- Non-tunneled central venous catheter: This type of CVC is appropriate for short-term access to your vein (less than two weeks). Your provider uses a needle puncture to access a vein in your neck, groin or upper chest. Your provider guides the catheter tip into your superior vena cava.
- Peripherally inserted central catheter (PICC): A PICC line is similar to a non-tunneled CVC. But your provider uses a needle puncture to access a vein in your upper arm instead of your neck or chest. Your provider threads the catheter through other veins until its tip reaches your superior vena cava.
- Tunneled central venous catheter: This type is appropriate for more than two weeks of access. Your provider surgically inserts the catheter into a vein in your neck or chest. The catheter “tunnels “under your skin for 8 to 10 centimeters and then exits through your skin in a different area of your chest. You may hear your provider call a tunneled CVC by its brand name. Common names are Broviac®, Hickman® and Groshong®.
- Subcutaneous (implanted) port: A port is appropriate for long-term access of at least three months. This type doesn’t exit through your skin at all. Your provider surgically implants it so that it’s completely within your body. The hub (catheter access point) is very close to the surface of your skin. So, your provider can puncture your skin with a needle to access the hub for your treatment. Your provider may call this type of catheter an implantable venous port or a Port-a-Cath.
Your provider will tell you which type of CVC you need. It depends on your specific medical needs and how long you need the catheter.
Who performs a central venous catheter placement?
A healthcare provider called a proceduralist performs placement of central lines. Proceduralists are physicians who specialize in certain medical procedures.
How common are central venous catheters?
Central line placement is a common procedure. Millions of people receive a central venous catheter every year.
FAQs
A central venous catheter is a thin, flexible tube that is inserted into a vein, usually below the right collarbone, and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs.
Where should a central venous catheter be placed? ›
There are three main access sites for the placement of central venous catheters, namely internal jugular, common femoral, and subclavian veins. These are the preferred sites for temporary prominent venous catheter placement.
What is the major benefit of a central venous catheter? ›
A central venous catheter has many advantages over peripheral IVs, including: Fewer needle sticks. A CVC allows your provider to access your vein many times without sticking your vein with a needle each time. This method protects your vein from damage.
What does a central venous catheter measure? ›
The central venous pressure can be measured using a central venous catheter advanced via the internal jugular vein and placed in the superior vena cava near the right atrium. A normal central venous pressure reading is between 8 to 12 mmHg. This value is altered by volume status and/or venous compliance.
Where is central venous catheter most common? ›
There are three common sites of central line insertion. These sites are the subclavian vein, the internal jugular vein, and the femoral vein.
How long can a central venous catheter stay in for? ›
With care, central venous catheters can remain tunneled in the body for several months without becoming infected. the catheter usually prevents the clots from blocking the tube. If the catheter becomes kinked, it must be repositioned or removed by your healthcare provider.
What conditions require a central line? ›
There are multiple indications for central line placement: Drug administration - vasopressors, chemotherapeutic agents, or hypertonic solutions are damaging to peripheral veins and often require the placement of a central line.
What are three indications for the use of a central line? ›
Indications
- Hemodynamic instability that requires vasopressor support.
- Need to instill hyperosmolar agents or agents known to cause vein scarring (phlebosclerosis)
- Inadequate peripheral IV access (either failure to obtain peripheral access anywhere, or needing multiple IVs to sustain and resuscitate a patient)
It may be associated with considerable discomfort in the conscious patient, as it requires him/her to stay in Trendelenburg position, head-extended with the neck fully turned to the opposite side and perfectly still. Local anesthetics such as lidocaine are commonly used to reduce pain during the procedure.
Can nurses insert central lines? ›
Central Line Nursing is the insertion, care, and maintenance of Central Line Catheters by trained nurses. Highly skilled nurse specialists typically will place the Central Lines, lines that end in a large vein above or below the heart, and other nurses will be responsible for the care and maintenance of the lines.
The CVC dressing is changed every 7 days if you are using a transparent dressing. Change it every 48 hours if you are using gauze or Telfa island dressing and tape. If the dressing becomes wet or loose, change it even if it is not the normal time to change it.
What is the most common complication of a central venous catheter? ›
The most common complications occurring during CVC application are: hearth arrhythmias, artery puncture, improper position of CVC and hematomas at the place of catheter insertion. If the top of the catheter enters the right hearth chambers, it can cause hearth arrhythmias by touching the hearth structures.
What are the disadvantages of central venous catheter? ›
Increased risk of infection. They all require routine care and maintenance to facilitate their effectiveness. Placement of CVADs poses a potential risk to the patient for developing bleeding, venous obstruction, cardiac tamponade, emboli, SVC/IVC obstruction and sepsis.
Why would a patient need a CVC? ›
Your doctor may use it to give you medicine for pain, infection, and other conditions, such as cancer or heart issues. They can also be used for taking samples for tests and to give you fluids, nutrients, and blood. For example, you might get a CVC if you need: A lot of blood tests.
What is the difference between a CVC and a PICC line? ›
Shape: CVCs are Y-shaped, whereas a PICC line has a standard tube shape like what you see in an IV. Types: You can receive one of two types of CVCs, and a PICC line has no subtypes. Bloodstream access: CVCs are designed to provide access to the blood, so they go deeper than PICC lines.
What is the difference between a peripheral and central venous catheter? ›
A central venous catheter differs from an intravenous (IV) catheter placed in the hand or arm (also called a “peripheral IV”). A central line is longer, with a larger tube, and is placed in a large (central) vein in the neck, upper chest or groin.
What is the difference between a central venous catheter and a dialysis catheter? ›
The main difference between a PD catheter and CVC when dialyzing is how the blood is filtered. With PD, no machine is used for dialysis. As mentioned before, the lining of your belly acts as the “filter” for cleaning the blood.
What is the difference between an arterial catheter and a central venous catheter? ›
Arterial lines are inserted into an artery — the blood vessels that carry blood away from the heart. Central lines (and all IVs) are inserted into a vein — the blood vessels that carry blood back to the heart. Central lines and IVs are used to give medications, but arterial lines are not.
