Central Line Placement
Establishing intravenous access is an essential and early step in most acute care situations. Cannulation of peripheral veins with short- and large-bore catheters is the initial choice as it provides quick access for initial resuscitation allowing rapid infusion of fluids and medications. Patients admitted to the intensive care unit, however, frequently require central venous access. Central venous catheters (CVCs) not only provide a route to administer a wide variety of medications necessary for the critically ill patient but can also be used to obtain hemodynamic and physiologic information at the bedside that aids in treatment decision making. In this chapter, we will discuss appropriate catheter site selection, review the pertinent anatomy and technique for insertion of CVCs, and discuss the potential complications and their management.
KeywordsCentral line Central venous catheter Internal jugular vein Subclavian vein Femoral vein Complications Pneumothorax
- 8.Baldea AJ Jr, Cocanour CS. Central line-associated blood stream infections. In: Cameron JL, Cameron AM, editors. Current surgical therapy. 11th ed. Philadelphia: Elsevier; 2014. p. 1259–62.Google Scholar
- 10.Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Brass P, editor. Cochrane Database Syst Rev. 1996;13(4):213.Google Scholar
- 11.Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Brass P, editor. Cochrane Database Syst Rev. 1996;111(3):S80.Google Scholar
- 14.Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45.CrossRefPubMedPubMedCentralGoogle Scholar