Alternative Names central venous catheter, CVP line
Definition A central line is a special intravenous, or IV, line that is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line has multiple ports that can be used to draw blood, give fluids, and monitor central venous blood pressure.
Who is a candidate for the procedure? A central line is used for:
gaining emergency IV access when the usual IV access into an arm vein is not possible
monitoring central venous pressure during major surgery, or after severe blood loss from trauma or illness
How is the procedure performed? A central line is inserted under sterile conditions. The person is usually placed in the Trendelenburg position, which means the head is below the level of the heart. The skin is cleansed and a local anaesthetic is injected to make the area numb. The line is advanced until it reaches the appropriate place in the large vein of the chest. The catheter is then sutured in place, and a sterile dressing is applied.
What happens right after the procedure? A chest x-ray will be done immediately after the central line is inserted. The line should not be used until the x-ray confirms that it is in the correct position. A central line can usually stay in place for up to 4 weeks.
What happens later at home? If the person is going home with the central line, the family will need to learn how to care for the catheter. A visiting nurse will be involved in the care. Dressings will need to be changed every 3 days. The insertion area should be inspected closely for signs of infection, including redness, drainage, and swelling.
What are the potential complications after the procedure? While inserting the line, it is possible to puncture the lung. The catheter may irritate the heart and cause irregular heartbeats, or arrhythmias. Other complications may include:
infection
bleeding
air embolism
blood clot in the tubing
Any of these complications may lead to the removal of the central line.
Author: Reviewer: eknohow Medical Review Panel Editor: Dr John Hearne Last Updated: 22/09/2004 Contributors Potential conflict of interest information for reviewers available on request
