[video] Central Venous Catheterization: Subclavian Vein

Central Venous Catheterization: Subclavian Vein

In medicine, a central venous catheter ("central line", "CVC", "central venous line" or "central venous access catheter") is a catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian vein) or groin (femoral vein). It is used to administer medication or fluids, obtain blood tests (specifically the "mixed venous oxygen saturation"), and directly obtain cardiovascular measurements such as the central venous pressure. Certain medications, such as inotropes and amiodarone, are preferably given through a central line.

Indications for the use of central lines include:

* Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance
* Long-term Intravenous antibiotics
* Long-term Parenteral nutrition especially in chronically ill patients
* Long-term pain medications
* Chemotherapy
* Drugs that are prone to cause phlebitis in peripheral veins (caustic), such as:
o Calcium chloride
o Chemotherapy
o Hypertonic saline
o Potassium chloride
o Amiodarone
* Plasmapheresis
* Dialysis
* Frequent blood draws
* Frequent or persistent requirement for intravenous access
* Need for intravenous therapy when peripheral venous access is impossible
o Blood
o Medication
o Rehydration

Central venous catheters usually remain in place for a longer period of time, especially when the reason for their use is longstanding (such as total parenteral nutrition in a chronically ill patient). For such indications, a Hickman line, a PICC line or a portacath may be considered because of their smaller infection risk. Sterile technique is highly important here, as a line may serve as a porte d'entrée (place of entry) for pathogenic organisms, and the line itself may become infected with organisms such as Staphylococcus aureus and coagulase-negative Staphylococci.

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Central Venous Catheterization: Subclavian Vein

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