Insertion and Management of Central Venous Catheters

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 longterm 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.