From the Guidelines
Yes, a femoral line is a type of central line, as it provides direct access to the central venous circulation through the femoral vein in the groin area. Central venous catheters (central lines) are categorized based on their insertion site, and the femoral vein is one of the common access points, along with internal jugular lines (placed in the neck) and subclavian lines (placed below the clavicle) 1. Femoral lines are often used in emergency situations because the femoral vein is relatively easy to locate and access, especially during cardiopulmonary resuscitation. However, femoral lines generally have higher infection rates compared to other central line sites due to their proximity to the groin area, which harbors more bacteria, and they also limit patient mobility and are more difficult to keep clean 1. For these reasons, femoral lines are typically used for shorter durations or when other access sites are unavailable. According to the most recent guidelines, insertion in the femoral vein should be avoided due to the increased risk of infection and thrombosis 1.
Some key points to consider when using femoral lines include:
- They are associated with a higher risk of infection and thrombosis compared to other central line sites 1
- They should be used for shorter durations or when other access sites are unavailable 1
- Insertion should be carried out under strict sterile conditions, in the operating room, using chlorhexidine solutions with alcohol 1
- Routine flushing with saline is recommended after completion of any infusion or blood sampling 1
It is essential to weigh the benefits and risks of using a femoral line and to consider alternative access sites whenever possible, in order to minimize the risk of complications and improve patient outcomes 1.
From the Research
Definition of Central Line
A central line is a type of catheter that is inserted into a large vein in the body, typically in the neck, chest, or arm, to deliver medication, fluids, or nutrients over a long period of time.
Types of Central Lines
- Subclavian central line: inserted into the subclavian vein in the chest
- Internal jugular central line: inserted into the internal jugular vein in the neck
- Femoral central line: inserted into the femoral vein in the groin
Is a Femoral Line a Type of Central Line?
Yes, a femoral line is a type of central line, as it is inserted into a large vein (the femoral vein) to deliver medication, fluids, or nutrients over a long period of time 2, 3, 4.
Comparison of Femoral and Internal Jugular Central Lines
Studies have compared the risks of catheter-related bloodstream infections (CRBSI) between femoral and internal jugular central lines. Some studies have found no significant difference in the risk of CRBSI between the two types of central lines 2, 3, while others have found a higher risk of CRBSI with femoral central lines 4.
- A study published in the American Journal of Respiratory and Critical Care Medicine found no difference in catheter-related bloodstream infection rates between internal jugular and femoral catheters 2
- A systematic review and meta-analysis published in Critical Care Medicine found no significant difference in the risk of CRBSI between femoral and subclavian/internal jugular central lines 3
- A cross-sectional study published in Cureus found a higher risk of CRBSI with femoral central lines compared to internal jugular central lines 4