Central venous catheter

Treatment Overview

A central venous catheter, also called a central line, is used to take blood and give chemotherapy and other drugs during treatment for cancer. It is inserted under your skin, usually in the large blood vessels in your chest, and left there during your treatment.

The catheter is made of flexible silicone rubber. During surgery the catheter is attached to your skin with stitches. It has a Dacron cuff near the skin opening that helps it stay in place and prevents bacteria from traveling up the catheter line. The catheter may have one, two, or three openings, called lumens, at the tip. Doctors and nurses insert needles into those tips when they need to draw blood or give you drugs or other kinds of treatment. Having the catheter means they do not have to stick needles into your skin every time.

What To Expect After Treatment

You may feel some discomfort after the catheter is inserted, but there are medicines to take care of that. The discomfort is temporary. You will learn how to take care of the catheter at home.

Before the surgery, you will be given a local anesthetic and other drugs to help you relax. This may make you drowsy, so you should not drive or operate machinery for 24 hours after the procedure.

After the catheter is inserted, your doctor will order X-rays to make sure the catheter is in the right spot.

You will not have to stay in the hospital after your catheter is inserted unless you are to receive high-dose chemotherapy as part of your treatment plan.

Why It Is Done

A central venous catheter is used to prevent the numerous needle sticks that would be needed during treatment for many types of cancer, especially leukemia and lymphoma. Also, chemotherapy can be hard on the small veins in the hands and arms. A central venous catheter delivers chemotherapy to the larger veins that can handle the drugs better than small veins.

How Well It Works

A central venous catheter successfully prevents the need for numerous needle sticks during treatment for many types of cancer, especially leukemia and lymphoma. Blood can be drawn from the catheter, and it can be used to give drugs, fluids, and blood or blood products.

Risks

Most people do not have any problems with their central venous catheters. If problems do develop, they can include the following:

• Infection can occur at the exit site. Infection can also travel up into the catheter when you flush it or receive medicine through it. There are things you can do to avoid an infection.
  • Keep the exit site clean and dry. Call your doctor if you see redness, tenderness, or any pus draining.
  • Wash your hands every time you flush the catheter or change the dressing.
  • Call your doctor if you develop a fever or chills.
• A blood clot may block the catheter. This may make it impossible to draw blood from the catheter or receive drugs through it. Flushing your catheter regularly will prevent this.
• A blood clot may form at the end of the catheter and block blood flow through the vein (thrombosis). This may cause pain or swelling in your neck, face, chest, or arm. If you experience these symptoms, call your doctor immediately.
• The catheter may break. This does not happen very often, but it can occur. Use your catheter clamp to clamp the catheter close to your skin. Call your doctor for additional instructions. Do not panic. Broken catheters can often be repaired.
• An air bubble can form and block your vein if the clamp has not been replaced and the cap is removed from the catheter. You may feel short of breath or begin to cough if this happens. Call your doctor immediately for additional instructions. Do not panic.

What To Think About

Your nurses will teach you how to take care of your catheter. You will learn how to change the dressing and flush your catheter. Call your doctor if you have questions or concerns.

It is very important that you treat your catheter carefully to avoid infection.

Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.

Author:	Kathe Gallagher, MSW	Last Updated: November 30, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Joseph O'Donnell, MD - Hematology/Oncology
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