CARE, USAGE, MAINTENANCE AND COMPLICATION
MANAGEMENT OF CENTRAL VENOUS CATHETERS (CVC)
1. Definition of Central Venous Catheter (CVC)
CVC is a small biocompatible tube or vascular access device made of soft flexible material inserted into a large vein of the peripheral vascular system and tip of the catheter advanced into the superior vena cava (SVC). The catheter insertion site may be an upper extremity, jugular vein or subclavian vein.
Radiographic studies are necessary to confum CVC placement.
Subclavian or axillary tip placement is not considered as a CVC.
SVC placement is required for administration of TPN and continues infusion of vesicant chemotherapy agents.
Indications for CVC
Long term therapies, poor venous access, continues administration of vesicant drugs, high pH or hypertonic solutions.
Catheter Materials
Catheter materials must be bio-compatible. Softer materials are harder to insert but are better as it is more bio-compatible less thrombogenic.
A. Silicone: Soft, used for long term catheters such as Hickman/Broviac. Groshong and Port-a-Cath.
B. Polyurethane or Teflon: Stiffer than silicon, such as triple lumen catheters and L-Cath.
C. Elastometric Hydrogel (Aquavene material): MenloCare catheters. Stiff when it is dry; softens, extends and expands when wet. Examples are Cetermark (PICC) and Landmark (Midline).
