Central Venous Catheter Placement in the ICU

 

Your doctor can place these into large veins found in patient’s neck, upper chest, leg, or arm.  These long, thin, hollow tubes are like the IVs placed in a patient’s arms except that they are placed in a bigger vein.  Central venous catheters (central lines) may be helpful if we are having trouble finding good veins in the patient’s arms.

 

There are common reasons for having a central catheter.  They include:

·        To give large amounts of fluid or blood quickly.

·        To measure how much fluid your body needs.

·        To give medicines through the veins for a week or longer.

·        To give medicines that can only be given through large central veins.

·        To obtain frequent blood samples without needle sticks.

·        To give special nutrition when foods or liquids can’t be given through the stomach or bowel.

 

Risks

 

As with any procedure, there are risks.  Some of the risks include:

·        Pain – Patients may feel a poke as the doctor inserts the needle.  Numbing medicine is used to lessen the pain.  Once the needle is in, the pain is often mild and goes away.

·        Collapsed lung – The lung is very close to veins in the neck and chest.  When a central catheteris placed in the chest area, if a needle passes through or misses the vein, the needle could pierce the lung and cause it to collapse. If this happens, a chest tube will be placed to reinflate the lung.  Rarely, a collapsed lung can result in death.  This may happen even if everything is done the right way.

·        Infection – Any tube entering the body can make it easier for bacteria from the skin to get into the bloodstream.  Special care in cleaning the skin and applying the dressing at the catheter site is done to decrease the risk of infection.

·        Bleeding – When the doctor inserts the needle, there is a risk of nicking a blood vessel.  If this happens, the bleeding is often minor and stops on its own.  Patients may notice a bruise.  Rarely, the chest can fill with blood which could be life-threatening.

·        Clotting around the catheter – Blood clots can form in and around the catheter.  If inside, they can plug up the catheter so that we can no longer use it.  These clots can break off and travel through the bloodstream into the lungs.  This could result in a serious breathing problem (embolism). 

·        Air in the catheter – Rarely, air enters the catheter while it is being placed.  The air bubbles may travel into the lungs causing severe breathing problems. 

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 10/23/2009

Copyright © 10/23/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6338

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