Central Line Catheters and Associated Complications: A Review.

Avani R Patel,Shivank Singh,Imran Khawaja,Shantanu Singh,Amar R Patel

doi:10.7759/cureus.4717

Abstract

The use of a central line or central venous catheterization was brought to attention in 1929 when Dr. Werner Forssmann self-inserted a ureteric catheter through his cubital vein and into the right side of his heart. Since that time the central line technique has developed further and has become essential for the treatment of decompensating patients. Central lines are widely used for anything from rapid fluid resuscitation, to drug administration, to parenteral nutrition, and even for administering hemodialysis. Central lines come in different sizes, types, and sites of administration. Sometimes their use can be associated with complications as well. The following review article addresses these parameters of central lines and goes into detail regarding their complications.

Highlights

BackgroundThe use of a central line is often crucial to the improvement of critically ill patients
It would be safer to deliver the vesicant drugs through a central line rather than through a peripheral line where there is a higher chance of drug leakage
The subclavian vein tends to have a lower infection rate as compared to other central line sites [2]. This is a review article that describes central lines, their different types, the sites of insertion, and the complications seen in association with them

Summary

Introduction

The use of a central line is often crucial to the improvement of critically ill patients. Any injury to the parietal pleura during insertion will lead to pneumothorax or pneumomediastinum formation They are seen most commonly with subclavian vein central lines and occur in about one percent of cases [16,22,24]. A lymphatic injury can still occur with a central line inserted into the right internal jugular vein or subclavian vein. Past research studies have noted the incidence of tracheal injuries during a central line insertion They were usually due to an accidental puncture of the trachea while trying to gain vascular access with either a “finder” needle or a larger bore needle used to advance the guide wire [14, 39]. The last known pulmonary complication is the development of an air embolism These can occur during a central line insertion or when flushing the venous catheter. A PICC line insertion can cause vascular complications like AV fistula formation and venous injury [14]

Conclusions

Disclosures

Hanafusa N

Vascular Access 2006 Work Group

Findings

42. Centers for Disease Control and Prevention