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5.2.3 - Central Venous Catheterisation

from Section 5.2 - Practical Cardiovascular System

Published online by Cambridge University Press:  27 July 2023

By
Oliver Sanders
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Ultrasound guidance is the gold standard of care for central line insertion.

  2. 2. The number of unsuccessful attempts at cannulation is directly proportional to the likelihood of subsequent complications.

  3. 3. Factors such as current clinical condition, body habitus, co-morbidities and intended duration of catheterisation should influence the choice of puncture site.

  4. 4. The length of guidewire and catheter used is determined by the side and site of insertion.

  5. 5. The puncture site should be regularly assessed for signs of infection – line-associated sepsis is a significant cause of morbidity in the critical care setting.

Keywords

central venous catheterCVCinvasive monitoringcentral lineSeldinger technique
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 567 - 570
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Maecken, T, Grau, T. Ultrasound imaging in vascular access. Crit Care Med 2007;35(5 Suppl):S178–85.CrossRefGoogle ScholarPubMed
Smith, R, Nolan, J. Central venous catheters. BMJ 2013;11:f6570.CrossRefGoogle Scholar
Waldman, C, Soni, N, Rhodes, A, Handy, J. Oxford Desk Reference: Critical Care, 2nd edn. Oxford: Oxford University Press; 2019.CrossRefGoogle Scholar

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