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Central Line (Central Venous Access Device)

You need a central line as part of your treatment. It’s also called a central venous access device (CVAD). A small, soft tube called a catheter is put in a vein that leads to your heart. When you no longer need the central line, it will be taken out. Your skin will then heal. This sheet describes types of central lines. It also explains how the central line is placed in your body.

Outline of human figure with catheter inserted into vein under collarbone. Two ports are at end of catheter. Catheter can be seen in vein into heart.
The catheter may have more than one lumen (channel). This means that different fluids or medications can be given at the same time.

What a central line does

A central line is often used instead of a standard IV (intravenous) line when you need treatment for longer than a week or so. The line can deliver medications or nutrition directly into your bloodstream. It can also be used to measure blood flow (hemodynamic monitoring), to draw blood, or for other reasons. Ask your doctor or nurse why you need the central line and which type you’ll get.

Types of central lines

The central line will be placed into one of the veins as described below. Which vein is used depends on your needs and overall health. The catheter is threaded through the vein until the tip sits in the large vein near the heart (vena cava). Types of central lines include:

  • Peripherally inserted central catheter (PICC): This line is placed in a large vein in the upper arm, or near the bend of the elbow.

  • Subclavian line: This line is placed into the vein that runs behind the collarbone.

  • Internal jugular line: This line is placed into a large vein in the neck.

  • Femoral line: This line is placed in a large vein in the groin.

Placing the central line

The central line is placed in your body during a brief procedure. This may be done in your hospital room or an operating room. Your health care team can tell you what to expect. During central line placement:

  • You’re fully covered with a large sterile sheet. Only the spot where the line will be placed is exposed. The skin is cleaned with antiseptic solution. These steps lower the risk for infection.

  • Medication (local anesthetic) is injected near the vein. This numbs the skin so you don’t feel pain during the procedure.

  • After the pain medication takes effect, the catheter is gently passed into the vein. It’s moved forward until the tip of the catheter is in the vena cava, close to the heart.

  • The other end of the catheter extends a few inches out from your skin. It may be loosely attached to the skin with stitches, to hold it in place.

  • The doctor flushes the catheter with saline solution to clear it. The solution may include heparin, which prevents blood clots.

  • An X-ray or other imaging test is done. This allows the doctor to confirm the catheter’s position and check for problems.

Risks and complications

As with any procedure, having a central line placed has certain risks. These include:

  • Infection

  • Bleeding problems

  • An irregular heartbeat

  • Injury to the vein or to lymph ducts near the vein

  • Inflammation of the vein (phlebitis)

  • Clots or air bubbles in the bloodstream

  • Collapsed lung (pneumothorax) or buildup of blood between the lungs and the chest wall (hemothorax)

  • Blockage of a blood vessel leading to the lung (pulmonary embolism)

  • Nerve injury

  • Accidental insertion into an artery instead of a vein

  • Catheter not positioned correctly

If you have any problems with your central line, talk to your health care provider.

Publication Source: Rupp, SM. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Forceon Central Venous Access. Anesthesiology (2012); 116(3); pp, 539-573
Online Source: Centers for Disease Control and Prevention. Basic Infection Control and Prevention Plan for Outpatient Oncology Settingshttp://www.cdc.gov/HAI/settings/outpatient/basic-infection-control-prevention-plan-2011/central-venous-catheters.html <a href="" target="_blank"></a>
Online Editor: Metzger, Geri
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Online Medical Reviewer: Turley, Ray, BSN, MSN
Date Last Reviewed: 10/1/2014
Date Last Modified: 10/8/2014
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