Central Line Placement

What is Central Line Placement?

Central line placement refers to the insertion of a catheter into a large vein in your body. A central line is big and may have up to 5 lumens which serve as ports through which blood can be drawn or fluids can be infused.

Why is a Central Line Used?

A central line may be placed in your body for numerous reasons including the following:.

  • To draw blood samples.
  • To perform dialysis where one of the lumens is used to draw impure blood and another lumen is used to return the purified blood to the body.
  • To administer large amounts of intravenous fluids.
  • For long-term intravenous (IV) therapy such as IV antibiotic treatment or chemotherapy.
  • To measure the central venous pressure which provides information about the volume of fluid in your circulatory system, and whether your body has too little or too much fluid.
  • If your central line is a Swann-Ganz type catheter, it can reveal the functioning of your heart’s left atrium by measuring your pulmonary wedge pressure. This information is useful for people who undergo heart surgery or suffer from serious heart conditions.

Contraindications for Central Line Placement

You may not be a candidate for a central line placement under the following conditions:

  • Trauma to local anatomy
  • Infection around the insertion site
  • Formation of thrombus (abnormal blood clots in the vein)
  • Hemorrhage: uncontrolled abnormal bleeding

What Sites are Used for a Central Line Placement?

The most common veins used for placement of a central line are the subclavian vein near the collarbone, the internal jugular vein in the neck and the femoral vein in the groin.

Procedure for Central Line Placement

To insert a central line, you will lie flat and be covered with a sterile drape from head to toe, excluding the region where the central line will be inserted. The sterile drape helps reduce the risk of infection.

  • After draping, your exposed skin will be cleaned. You may also be administered a local anesthetic .
  • After cleaning, the central line is inserted into the selected vein under the guidance of ultrasound. Then, the central line catheter is either stitched in place or held in place at the insertion site with the help of adhesive.
  • After placing the central line, the exposed area is re-cleaned with an antiseptic and a sterile dressing is placed over the insertion site, carefully ensuring that the lumens remain accessible.
  • An X-ray will be taken after placing the central line to confirm placement into the correct vein.

Risks and Complications Associated with Central Line Placement

You may contract a Central Line Associated Bloodstream Infection (CLABSI) if:

  • The sterility of the dressing or your full body drape is not maintained during placement of the central line
  • Central line is retained despite being no longer necessary

Other risks include:

  • Alteration in the heart's rhythm due to irritation caused during insertion of central line.
  • Pneumothorax, also called collapsed lung, if the central line is placed in the subclavian vein.
  • Air embolism: Air enters your blood circulation and starts travelling throughout your body. a serious and rare complication.