What is a central line (Central Venous Catheter, CVC)?

From the Guidelines

A central line, also known as a Central Venous Catheter (CVC), is a medical device used to access a patient's venous system for the administration of medications, fluids, or blood products, and is typically inserted into a large vein in the neck, chest, or groin. According to the Annals of Oncology guidelines 1, there are four main classifications of CVCs, including non-tunnelled catheters, tunnelled central catheters, fully implantable or surgically implantable catheters, and Peripherally Inserted Central Catheters (PICCs).

Key Characteristics of CVCs

• Non-tunnelled catheters are indicated for short-term use
• Tunnelled central catheters are used for long-term access (>30 days)
• Fully implantable catheters are associated with a low risk of infection
• PICCs are placed via a peripheral vein and have a higher risk of thrombosis

Insertion and Maintenance

To insert a central line, the following steps are recommended:

1. Choose the site carefully, with the internal jugular, subclavian, or femoral vein being common options, although the femoral vein should be avoided unless there is a contraindication to the other sites 1
2. Use sterile technique and local anesthesia, with chlorhexidine solutions with alcohol being the preferred antiseptic 1
3. Insert the catheter using ultrasound guidance, which has been shown to increase the success rate of first insertion attempts 1
4. Confirm placement with chest X-ray or intraoperative fluoroscopy, to ensure the catheter tip is in the correct position 1 To maintain the line, it is recommended to:

• Flush with saline regularly, with the frequency depending on the type of catheter and its usage 1
• Monitor for signs of infection or complications, such as fever, redness, or swelling at the insertion site 1 By following these guidelines, healthcare professionals can ensure the safe and effective use of central lines, minimizing the risk of complications and improving patient outcomes.

From the Research

Definition of Central Line (Central Venous Catheter, CVC)

• A central line, also known as a Central Venous Catheter (CVC), is a type of vascular access device used for patients who require long-term or short-term venous access for medical treatment 2.
• CVCs are used in various branches of medicine, including oncology, pediatrics, and intensive care units, to administer medications, fluids, and nutrients directly into the bloodstream 3, 2.

Types and Uses of Central Venous Catheters

• There are different types of CVCs available, including peripherally inserted central catheters (PICCs) and centrally inserted central catheters, each with its own advantages and disadvantages 4, 5.
• CVCs are used for various purposes, such as administering chemotherapy, parenteral nutrition, and antibiotics, as well as for blood draws and monitoring vital signs 6, 3.

Care and Maintenance of Central Venous Catheters

• Proper care and maintenance of CVCs are crucial to prevent central line-associated bloodstream infections (CLABSIs) and other complications 6, 4, 3.
• Evidence-based nursing interventions, such as hand hygiene, maximal sterile barrier, and chlorhexidine antiseptic, are essential for preventing CLABSIs and ensuring the safe use of CVCs 6, 4.