Central venous catheterization - Revision history

Rossdonaldson1: /* Background */

2025-07-30T19:55:27Z

Background

← Revisión anterior		Revisión del 19:55 30 jul 2025
Línea 4:		Línea 4:
	**Internal jugular (IJ)		**Internal jugular (IJ)
	**Subclavian		**Subclavian
			***Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.<ref>[[EBQ:3SITES Trial\|3SITES Trial]]</ref>
	**Femoral		**Femoral
	*Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.<ref>[[EBQ:3SITES Trial\|3SITES Trial]] </ref>
	*The major [[CVC catheter problems\|complications]] of concern include:		*The major [[CVC catheter problems\|complications]] of concern include:
	**[[~~catheter~~-related bloodstream infections]] (CRBI)		**[[Catheter-related bloodstream infections]] (CRBI)
	**[[DVT]]		**[[DVT]]
	**Mechanical complications (e.g. [[pneumothorax]] and [[arterial puncture]])		**Mechanical complications (e.g. [[pneumothorax]] and [[arterial puncture]])

Rossdonaldson1: /* Background */

2025-07-30T19:53:41Z

Background

← Revisión anterior		Revisión del 19:53 30 jul 2025
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	==Background==		==Background==
	Central venous catheters (CVCs) are often required to establish venous access in critically ill patients in order to administer rapid [[fluid resuscitation]], [[blood products]], and [[vasopressors]]. The sites of insertion fall into three locations: Internal jugular (IJ), subclavian, ~~and femoral~~. The major [[CVC catheter problems\|complications]] of concern include: catheter-related bloodstream infections (CRBI), [[DVT]]~~, and mechanical~~ complications (e.g. pneumothorax and arterial puncture).		*Central venous catheters (CVCs) are often required to establish venous access in critically ill patients in order to administer rapid [[fluid resuscitation]], [[blood products]], and [[vasopressors]].
			*The sites of insertion fall into three locations:
	~~The [[EBQ:3SITES Trial\|3SITES Trial~~]] study, a multicenter randomized trial, investigated the complications of the three anatomic sites for CVC insertion in relation to blood stream infections or DVTs. Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.		**Internal jugular (IJ)
			**Subclavian
			**Femoral
			*Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.<ref>[[EBQ:3SITES Trial\|3SITES Trial]] </ref>
			*The major [[CVC catheter problems\|complications]] of concern include:
			**[[catheter-related bloodstream infections]] (CRBI)
			**[[DVT]]
			**Mechanical complications (e.g. [[pneumothorax]] and [[arterial puncture]])

	==Types==		==Types==

Rossdonaldson1: /* Background */

2025-07-30T19:51:18Z

Background

← Revisión anterior		Revisión del 19:51 30 jul 2025
Línea 1:		Línea 1:
	==Background==		==Background==
	Central venous catheters(CVCs) are often required to establish venous access in critically ill patients in order to administer rapid [[fluid resuscitation]], [[blood products]], and [[vasopressors]]. The sites of insertion fall into three locations: Internal jugular (IJ), subclavian, and femoral. The major [[CVC catheter problems\|complications]] of concern include: catheter-related bloodstream infections (CRBI), [[DVT]], and mechanical complications (e.g. pneumothorax and arterial puncture).		Central venous catheters (CVCs) are often required to establish venous access in critically ill patients in order to administer rapid [[fluid resuscitation]], [[blood products]], and [[vasopressors]]. The sites of insertion fall into three locations: Internal jugular (IJ), subclavian, and femoral. The major [[CVC catheter problems\|complications]] of concern include: catheter-related bloodstream infections (CRBI), [[DVT]], and mechanical complications (e.g. pneumothorax and arterial puncture).

	The [[EBQ:3SITES Trial\|3SITES Trial]] study, a multicenter randomized trial, investigated the complications of the three anatomic sites for CVC insertion in relation to blood stream infections or DVTs. Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.		The [[EBQ:3SITES Trial\|3SITES Trial]] study, a multicenter randomized trial, investigated the complications of the three anatomic sites for CVC insertion in relation to blood stream infections or DVTs. Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.

Rossdonaldson1: /* Background */

2025-07-30T19:50:01Z

Background

← Revisión anterior		Revisión del 19:50 30 jul 2025
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	==Background==		==Background==
	{{CVC ~~main points}}~~		Central venous catheters(CVCs) are often required to establish venous access in critically ill patients in order to administer rapid [[fluid resuscitation]], [[blood products]], and [[vasopressors]]. The sites of insertion fall into three locations: Internal jugular (IJ), subclavian, and femoral. The major [[CVC catheter problems\|complications]] of concern include: catheter-related bloodstream infections (CRBI), [[DVT]], and mechanical complications (e.g. pneumothorax and arterial puncture).

			The [[EBQ:3SITES Trial\|3SITES Trial]] study, a multicenter randomized trial, investigated the complications of the three anatomic sites for CVC insertion in relation to blood stream infections or DVTs. Although subclavian lines appear to have a lower infection rate, there is greater incidence of mechanical complications.

	==Types==		==Types==

Rossdonaldson1: /* See Also */

2025-07-30T19:47:57Z

Benalexander: Include link to CVC complications page.

2025-07-29T12:06:39Z

Include link to CVC complications page.

← Revisión anterior		Revisión del 12:06 29 jul 2025
Línea 38:		Línea 38:
	*8.5 Fr [[Sheath introducer\|Cordis/introducer sheath]] with pressure bag: 20.0 L/hr		*8.5 Fr [[Sheath introducer\|Cordis/introducer sheath]] with pressure bag: 20.0 L/hr

	==Complications==		==[[CVC catheter problems\|Complications]]==
	''Complications vary by site''		''Complications vary by site''
	*[[Pneumothorax]] (more common with subclavian)		*[[Pneumothorax]] (more common with subclavian)

Cmb23: /* Depths */

2023-10-29T01:49:13Z

Depths

← Revisión anterior		Revisión del 01:49 29 oct 2023
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	==Depths==		==Depths==
	*All +/- 2 cm		*All +/- 2 cm
	*Right IJ - 13 cm		*Right IJ - 13 cm or height (cm)/10
	*Right subclavian - 15 cm		*Right subclavian - 15 cm or height (cm)/10 - 2cm
	*Left IJ - 15 cm		*Left IJ - 15 cm or height (cm)/10 + 4cm
	*Left subclavian - 17 cm		*Left subclavian - 17 cm or height (cm) + 2cm

	{{Central line indications}}		{{Central line indications}}

Elcatracho: /* Complications */

2021-04-24T14:46:16Z

Complications

← Revisión anterior		Revisión del 14:46 24 abr 2021
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	==Complications==		==Complications==
	''Complications vary by site''		''Complications vary by site''
	*Pneumothorax (more common with subclavian)		*[[Pneumothorax]] (more common with subclavian)
	*Arterial puncture (more common with femoral)		*Arterial puncture (more common with femoral)
	*Catheter malposition		*Catheter malposition
	*Subcutaneous hematoma		*Subcutaneous hematoma
	*Hemothorax		*[[Hemothorax]]
	*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]		*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]
	*Catheter induced thrombosis		*Catheter induced thrombosis
	*Arrhythmia (usually from guidewire insertion)		*[[Arrhythmia]] (usually from guidewire insertion)
	*Venous air embolism (avoid with Trendelenburg position)		*Venous air embolism (avoid with Trendelenburg position)
	*Bleeding		*[[Hemorrhagic shock\|Bleeding]]

	==Removal==		==Removal==

Elcatracho: /* Central Line */

2021-01-23T03:17:18Z

Central Line

← Revisión anterior		Revisión del 03:17 23 ene 2021
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	*7 Fr TLC 18G proximal port: 3.4 L/hr		*7 Fr TLC 18G proximal port: 3.4 L/hr
	*12 Fr HD: 23.7 L/hr		*12 Fr HD: 23.7 L/hr
	*8.5 Fr Cordis/introducer sheath: 7.6 L/hr		*8.5 Fr [[Sheath introducer\|Cordis/introducer sheath]]: 7.6 L/hr
	*8.5 Fr Cordis/introducer sheath with pressure bag: 20.0 L/hr		*8.5 Fr [[Sheath introducer\|Cordis/introducer sheath]] with pressure bag: 20.0 L/hr

	==Complications==		==Complications==

Elcatracho: /* Types */

2021-01-23T03:16:02Z

Types

← Revisión anterior		Revisión del 03:16 23 ene 2021
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	*[[Central line: femoral]]		*[[Central line: femoral]]
	*[[Pediatric central line]]		*[[Pediatric central line]]
			*[[Sheath introducer]]
	*Peripherally Inserted Central Catheter (PICC)		*Peripherally Inserted Central Catheter (PICC)

← Revisión anterior		Revisión del 19:47 30 jul 2025
Línea 55:		Línea 55:

	==See Also==		==See Also==
			*[[CVC catheter problems]]
	*[https://emcrit.org/central-lines/ Central Line Placement Videos from EMCRIT]		*[https://emcrit.org/central-lines/ Central Line Placement Videos from EMCRIT]
	*[https://emcrit.org/emcrit/microskills-dilation/ Central Line Micro Skills from EMCRIT]		*[https://emcrit.org/emcrit/microskills-dilation/ Central Line Micro Skills from EMCRIT]