Placement of a thin tube under ultrasound guidance into the large veins of the neck, beneath the collarbone, or in the groin. It is used for intensive treatment, nutrition, and medication delivery.
Indication
- Patients in whom peripheral venous access cannot be established
- Long-term intravenous treatment (chemotherapy, antibiotics, parenteral nutrition)
- Monitoring of central venous pressure in intensive care patients
- Procedures requiring high flow such as hemodialysis or plasmapheresis
- Safe administration of medications that can damage vessels (vasopressors, hypertonic solutions)
- Cardiac catheterization and temporary pacemaker placement
Preparation
- Coagulation tests (PT, aPTT, INR) and platelet count are checked
- Blood-thinning medications are planned appropriately
- The procedure area is cleaned and hair removal may be needed
- The patient is positioned supine; for jugular access, the head is tilted slightly back
- Informed consent is obtained and possible complications are explained
How it's performed
- The patient's heart rhythm, oxygen, and blood pressure are continuously monitored
- Local anesthesia is applied; mild sedation can be added if needed
- The skin is sterilized, sterile drapes are placed, and the physician puts on a sterile gown and gloves
- The target vein (jugular, subclavian, or femoral) is visualized with an ultrasound device
- The vein is entered with a needle, a guidewire is advanced, and the catheter is placed over the wire into the vein
- Correct catheter position is confirmed with a chest X-ray or ultrasound
Post-procedure
- After jugular/subclavian catheterization a chest X-ray is taken to check for pneumothorax
- The catheter entry site is checked daily for signs of infection
- Dressings are changed at regular intervals under aseptic conditions
- When the catheter is no longer needed it is removed under sterile conditions
- Time in place is kept as short as possible to reduce the risk of infection
Risks
- Pneumothorax — injury to the pleura, especially with subclavian placement
- Vessel injury, hematoma, and bleeding
- Catheter-related bloodstream infection
- Clot formation at the catheter tip (thrombosis)
- Malposition or accidental catheter dislodgement from the vein
- Air embolism (rare but serious)
FAQ
Is the procedure painful?
The area is numbed with local anesthesia, so during the procedure you feel pressure rather than pain; afterwards there may be mild tenderness at the insertion site.
How long can it stay in place?
The duration depends on the purpose, ranging from a few days to several months; tunneled catheters and ports can remain in place for months.
Can I bathe?
The dressing must not become wet; if you take a shower, covering the area with a waterproof dressing is recommended.
Is removal difficult?
It is usually a simple bedside procedure; afterwards, pressure is applied to the entry site for a few minutes.
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