Central Venous Catheterization

Posted by e-Medical PPT Saturday, August 28, 2010
Central venous catheter is a catheter placed into a large vein in the neck (internal jugular vein or external jugular vein,subclavian vein or femoral vein). It is used to administer medication or fluids, obtain blood tests , and directly obtain cardiovascular measurements such as the central venous pressure.

There are several types of central venous catheters
  • Open-ended tunneled catheters
  • Tunneled valved catheters
  • Implanted ports
  • Nontunneled central venous catheters (CVCs)
  • Peripherally inserted central catheters (PICCs)
Indications for Central Venous Catheterization
  1. Long-term Intravenous antibiotics,pain medications and Chemotherapy
  2. Long-term Total Parenteral nutrition especially in chronically ill patients
  3. Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance
  4. Plasmapheresis
  5. Dialysis
  6. Recurrent blood draws
  7. Need for intravenous therapy when peripheral venous access is impossible
Central line insertion may cause a number of complications.
  • Pneumothorax is thought to be higher with subclavian vein catheterization. In catheterization of the internal jugular vein, the risk of pneumothorax can be minimized by the use of ultrasound guidance.
  • All catheters can introduce bacteria into the bloodstream, but CVCs are known for occasionally causing Staphylococcus aureus and Staphylococcus epidermidis sepsis.
  • Other complications are air embolus,Arterial puncture,Hemorrhage and Arrhythmia may occur during the insertion process when the wire comes in contact with the endocardium.

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