Hanyang Med Rev.  2011 Feb;31(1):23-31. 10.7599/hmr.2011.31.1.23.

Insertion and Management of Central Venous Catheters

• Bae JI

• KMID: 2053748
• DOI: http://doi.org/10.7599/hmr.2011.31.1.23

Abstract

The indications for placement of central venous catheters are continually expanding. The rapid growth of hemodialysis services, transplantation programs, and oncologic centers has contributed to the need for maintaining patients who require parenteral nutrition, hemodialysis, plasmapheresis, blood transfusion, blood sampling, and long-term chemotherapy for various neoplastic and infections disease. There are three basic categories of venous catheters: non-tunneled catheters, tunneled catheters and implantable ports. Each category of non-tunneled and tunneled catheter divided to infusion and high flow hemodialysis catheter. Peripherally inserted central catheter is a unique long non-tunneled catheter inserted through an arm vein. All physicians should have a deep understanding of each central venous catheters and ability to select the most appropriate one for each patient. Central venous catheterization should be performed by experts with imaging guidance. The high failure rate and high complication rate in the landmark bedside technique was revealed due to anatomical variance of veins. Appropriate management of the catheter is one of the most important parts should be understood by nurses as well as physician in central venous catheterization.

Keyword

Veins; procedure; Veins; Catheterization

MeSH Terms

Arm
Blood Transfusion
Catheterization
Catheterization, Central Venous
Catheters
Central Venous Catheters
Humans
Parenteral Nutrition
Plasmapheresis
Renal Dialysis
Transplants
Veins

Figure

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  Fig. 1 Venous anatomy of the neck.

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  Fig. 2 Central veins of the upper trunk. RAV, right axillary vein; LAV, axillary vein; CV, cephalic vein; RSCV, right subclavian vein; LSCV, left subclavian; RBCV, right brachiocephalic vein; LBCV, left brachiocephalic vein; LIJV, left internal jugular vein; SVC, superior vena cava.

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  Fig. 3 Tunneled catheters. A) a 12F Hickman/Broviac tunneled infusion catheter. The arrow indicates a cuff. B) a tunneled cuffed hemodialysis catheter. The arrow also indicates a cuff. Note a staggered end of the catheter for prevention of re-circulation.

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  Fig. 4 Non-tunneled catheters and PICC. A) an 13.5F Non-tunneled non-cuffed hemodialysis catheter with a staggered end. There is no cuff in the shaft. B)12.5F Non-tunneled non-cuffed hemodialysis catheter with a side holes. C) 5F peripherally inserted central catheter.

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  Fig. 5 Venous port. A) an 8F silicon catheter (small arrow) and an implantable port (large arrow). B) A non-coring needle.

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