Catheterization of the subclavian vein is appropriate for all of the following uses except:
|A||Central venous pressure monitoring|
|C||Total parenteral nutrition|
A. A central venous catheter ("central line", "CVC", "central venous line" or "central venous access catheter") is a catheter placed into a large veinin the neck (internal jugular vein), chest (subclavian vein or axillary vein) or groin (femoral vein). It is used to administer medication or fluids, obtain blood tests (specifically the "mixed venous oxygen saturation"), and directly obtain cardiovascular measurements such as the central venous pressure.
B. Indications for the use of central lines include:
a. Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance
b. Long-term Intravenous antibiotics
c. Long-term Parenteral nutrition especially in chronically ill patients
d. Long-term pain medications
f. Drugs that are prone to cause phlebitis in peripheral veins (caustiC., such as:
i. Calcium chloride
iii. Hypertonic saline
vi. vasopressors (e.g. epinephrine, dopaminE.
h. Peripheral blood stem cell collections
j. Frequent blood draws
C. Central venous catheters usually remain in place for a longer period of time than other venous access devices, especially when the reason for their use is longstanding (such as total parenteral nutrition in a chronically ill patient).
E. Sterile technique is highly important here, as a line may serve as a porte d'entrée (place of entry) for pathogenic organisms, and the line itself may become infected with organisms such as Staphylococcus aureusand coagulase-negative Staphylococci.