From the Guidelines
Central venous catheters most commonly experience fracture during removal. To minimize the risk of breakage, it is recommended to use a gentle and steady technique when removing the catheter, and to consider using a catheter securement device to stabilize the catheter during the extraction process 1.
- Key factors that increase the risk of catheter fracture include:
- Catheter securement devices can help prevent fracture by stabilizing the catheter in place 1
- Having a trained healthcare professional perform the extraction and being prepared for potential complications can help mitigate the risk of breakage 1
- It is essential to be aware of the signs of a fractured catheter, including local swelling, pain, or skin site leakage on injection, as well as resistance on injection 1
From the Research
Central Venous Catheter Fracture
- Central venous (CV) catheters can experience fracture during removal, particularly if they are stuck in a central vein and pulled too hard 2.
- The mechanics of central venous catheter breakage have been described, and solutions have been proposed to minimize the possibility of catheter fracture during removal 2.
- While the provided studies do not specifically compare the frequency of fracture during insertion versus removal, they suggest that removal can be a complicated process that may lead to catheter fracture 2, 3.
- Complications associated with central venous catheters, including catheter separation, severance, break, rip, puncture, or leak, have been reported, but the studies do not specify when these complications most commonly occur 4, 5.
- A systematic review and meta-analysis of complication rates of central venous catheters found that placement complications, such as arterial puncture and pneumothorax, can occur during insertion, but did not specifically address catheter fracture during insertion or removal 6.