Risks and Complications of a Central Venous Catheter

Risks and Complications of a Central Venous Catheter

A central venous catheter (CVC) is used in the treatment of diseases that require permanent or long-term venous access.central venous catheter The procedure involves the insertion of a plastic tube into a major vein such as the subclavian or internal jugular vein, or the femoral vein. The inserted catheter may have one or more lumens, and is usually connected to a syringe that allows for fluid withdrawal and delivery or medication administration. It may be used for dialysis, blood transfusions, nutrition, chemotherapeutic agents, and other functions. The procedure carries the risk of infection, air embolism, blood clots, device malfunction or failure, and damage to an adjacent organ.

A CVC requires routine cleaning and sterile dressing changes. The device may also need to be flushed with a sterile solution to prevent it from becoming blocked when not in use. The health care team will teach the patient and family about caring for the catheter before discharge. Preparing children for tests and procedures can lower anxiety levels, encourage cooperation and help develop coping skills.

The risk of complications from a central line depends on the reason it was placed and the type of CVC in place. For example, a heparin-coated catheter is more likely to cause a blood clot than a nonheparin-coated catheter. The person who needs the line should be off any medications that affect blood clotting for at least 24 hours before the procedure.

Infection is the most common complication of a CVC. It is often caused by a bacteria or fungus and can occur in the skin around the catheter or in a vein where the catheter has been placed. The infection can spread to other parts of the body and be serious.

Another serious complication is arterial puncture (a puncture into an artery). The blood in the arteries contains a higher level of oxygen than the blood in the veins, and it moves faster through the lungs. A prolonged arterial puncture can lead to a stroke or a thrombus. In a study, arterial punctures occurred in 4.2% to 9.3% of central line placements.

Other problems with a central line can include an air embolism or a blood clot that can block blood flow to the heart, lungs or brain. The complication can happen during the insertion of a central line or when flushing the catheter.

During the insertion of a central line, an X-ray is done to make sure it goes into the correct location. A heart-monitoring device is sometimes attached to the catheter to monitor blood pressure and circulation. Sometimes the nurse or doctor might put a small cap on the end of the catheter to keep it free from germs. The cap stays on the end of the catheter when not in use.

During the insertion of a central venous catheter, it is important to make sure that the catheter goes into a vein in the right place. The nurse will check the blood pressure in the arm and the heart-monitoring device to see if the catheter is in the right place. A nurse or doctor will also do an X-ray to make sure the catheter is in the correct place.