What is a central venous catheter?

A central venous catheter (CVC), also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. The catheter makes doing these things more comfortable for you because they are put directly into the catheter. You are not poked with a needle every time. The catheter may be used to draw blood for tests only if another vein, such as in the hand or arm, can't be used.

The CVC is inserted in your arm, chest, neck, or groin. It is put through the skin and into a large vein. The catheter is threaded through this vein until it reaches a large vein near the heart. In most cases, the other end of the catheter—the end used to give medicines—sticks out of the skin.

Some of the common CVCs that are used outside the hospital or for longer periods of time include:

• A peripherally inserted central catheter, or PICC line (say "pick"). It usually goes into a vein in your arm.
• A tunnelled catheter, which is surgically inserted into a vein in the neck or chest.
• An implanted port. This is similar to a tunnelled catheter but is left entirely under the skin. Medicines are injected through a "port" placed under the skin.

After your CVC is in place, you may stay in the hospital to receive your medicines. Or you may get your medicines at home.

What problems can occur?

Possible problems with a central venous catheter include:

• Bleeding. This may happen when the doctor inserts the catheter. It's usually mild and will stop by itself.
• Infection. If infection occurs, you will need antibiotics or the catheter will be removed.
• Blockage or kinking of the catheter. Regular flushing of the catheter helps reduce blockage. A kinked catheter must be repositioned or replaced.
• Pain. You may feel pain at the place where the catheter is inserted or where it lies under your skin.
• Collapsed lung (pneumothorax). This is rare. It's most likely to happen during placement of a catheter in the chest.
• Shifting of the catheter. A catheter that has moved out of place can sometimes be repositioned. If this doesn't work, it must be replaced.

What happens when you get a central venous catheter?

When you are in the hospital, a nursing team will take care of you and your CVC.

Insertion and care of the CVC

Your nursing team will:

• Check the catheter site and dressing regularly. How often this is done depends on the situation.
• Wash their hands before and after handling the catheter.
• Replace the catheter when needed.
• Clean or replace the catheter components when needed.

Changing the dressing

Your team will:

• Use clean and proper materials for the dressing, which covers the catheter site.
• Clean the insertion site and area whenever they change the dressing.
• Replace the dressing when it is damp, loose, or dirty. It will be changed at least once a week.

At home

If you go home with a CVC, your team will give you detailed instructions on how to care for it. In general:

• Always wash your hands before you touch your CVC. Make sure anyone who touches the catheter also washes their hands.
• Try to keep the exit site dry. This can help prevent infection. When you shower, cover the site with waterproof material, such as plastic wrap. Be sure you cover both the exit site and the CVC cap(s).
• Fasten or tape the CVC to your body to prevent it from pulling or dangling. Avoid bending or crimping your CVC. And wear clothing that doesn't rub or pull on it.