Central venous catheterization

Central venous catheterization

Central venous catheterization is a medical procedure where a catheter is inserted into a large vein, typically in the neck (internal jugular vein), chest (subclavian vein), or groin (femoral vein). This procedure is commonly performed to administer medications, fluids, obtain blood tests, and measure central venous pressure.

Indications

Central venous catheterization is indicated in several clinical situations:

• Administration of medications that are caustic to smaller veins, such as chemotherapy or hypertonic saline.
• Long-term intravenous antibiotics, nutrition, or medications.
• Hemodynamic monitoring in critically ill patients.
• Immediate and rapid volume resuscitation.
• Repeated blood sampling.

Procedure

The procedure involves several key steps:

1. Preparation: Ensuring all necessary equipment is available and sterile. The patient is typically placed in a supine position.
2. Site Selection: Choosing the appropriate site based on the patient's condition and the intended use of the catheter.
3. Ultrasound Guidance: Often used to increase the success rate and reduce complications by visualizing the vein.
4. Insertion: The catheter is inserted using aseptic techniques to minimize the risk of infection.
5. Confirmation: Correct placement of the catheter is typically confirmed with an X-ray to ensure that it is positioned correctly within the central venous system.

Complications

Complications of central venous catheterization may include:

• Infection, leading to sepsis
• Pneumothorax, especially with subclavian vein catheterization
• Hematoma or arterial puncture
• Catheter malposition
• Thrombosis

Aftercare

Proper aftercare is crucial to minimize complications. This includes regular site inspection, maintaining catheter stability, and ensuring sterile handling during any manipulation.

See also

• Peripheral venous catheter
• Intravenous therapy
• Sepsis