Intravenal - Intravenous Access Devices - Central IV Lines

Central IV Lines

Central IV lines flow through a catheter with its tip within a large vein, usually the superior vena cava or inferior vena cava, or within the right atrium of the heart. This has several advantages over a peripheral IV:

• It can deliver fluids and medications that would be overly irritating to peripheral veins because of their concentration or chemical composition. These include some chemotherapy drugs and total parenteral nutrition.
• Medications reach the heart immediately, and are quickly distributed to the rest of the body.
• There is room for multiple parallel compartments (lumen) within the catheter, so that multiple medications can be delivered at once even if they would not be chemically compatible within a single tube.
• Caregivers can measure central venous pressure and other physiological variables through the line.

Central IV lines carry risks of bleeding, infection, gangrene, thromboembolism and gas embolism (see Risks below). They are often more difficult to insert correctly as the veins are not usually palpable and rely on an experienced clinician knowing the appropriate landmarks and/or using an ultrasound probe to safely locate and enter the vein. Surrounding structures, such as the pleura and carotid artery are also at risk of damage with the potential for pneumothorax or even cannulation of the artery.

There are several types of central IVs, depending on the route that the catheter takes from the outside of the body to the vein.