Central Venous Catheter - Indications and Uses

Indications and Uses

Indications for the use of central lines include:

• Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance
• Long-term Intravenous antibiotics
• Long-term Parenteral nutrition especially in chronically ill patients
• Long-term pain medications
• Chemotherapy
• Drugs that are prone to cause phlebitis in peripheral veins (caustic), such as:
  • Calcium chloride
  • Chemotherapy
  • Hypertonic saline
  • Potassium chloride
  • Amiodarone
  • vasopressors (e.g. epinephrine, dopamine)
• Plasmapheresis
• Peripheral blood stem cell collections
• Dialysis
• Frequent blood draws
• Frequent or persistent requirement for intravenous access
• Need for intravenous therapy when peripheral venous access is impossible
  • Blood
  • Medication
  • Rehydration

Central venous catheters usually remain in place for a longer period of time than other venous access devices, especially when the reason for their use is longstanding (such as total parenteral nutrition in a chronically ill patient). For such indications, a Hickman line, a PICC line or a portacath may be considered because of their smaller infection risk. Sterile technique is highly important here, as a line may serve as a porte d'entrée (place of entry) for pathogenic organisms, and the line itself may become infected with organisms such as Staphylococcus aureus and coagulase-negative Staphylococci.