Merck Manual

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Central Venous Catheterization

By

Thomas Cascino

, MD, MSc, Michigan Medicine, University of Michigan;


Michael J. Shea

, MD, Michigan Medicine at the University of Michigan

Reviewed/Revised Jul 2021 | Modified Sep 2022
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In central venous catheterization, a catheter is inserted into one of the large veins of the neck, upper chest, or groin. This procedure is most often used to give intravenous fluids or drugs when a catheter cannot be inserted into an arm or a leg vein (peripheral intravenous catheter).

Central venous catheterization is occasionally used to monitor central venous pressure (pressure in the superior vena cava, the large vein that returns blood to the heart from the upper part of the body). Central venous pressure reflects the pressure in the right atrium when it is filled with blood. This measurement helps doctors estimate whether the person is dehydrated and how well the heart is functioning. But it has largely been replaced by pulmonary artery catheterization Pulmonary Artery Catheterization The pulmonary artery is the artery that carries blood from the right side of the heart into the lungs. In pulmonary artery catheterization, a catheter is passed through the right atrium and... read more .

Because central venous catheters are larger than a regular intravenous (IV) catheter and the veins in which they are placed are deeper, doctors usually inject a local anesthetic before doing the procedure. They also take precautions to prevent infection, such as covering the person with sterile drapes and wearing sterile gown and gloves.

Serious complications are rare. Complications include inadvertently puncturing the artery that typically runs alongside large veins, bleeding, infection, and, for chest veins, puncturing the lung and causing a pneumothorax Pneumothorax A pneumothorax is partial or complete collapse of the lung due to the presence of air between the two layers of pleura (thin, transparent, two-layered membrane that covers the lungs and also... read more Pneumothorax .

Catheter in a Chest Vein

This figure shows the blood vessel (subclavian vein) in the chest that can be used for central venous catheterization.

Catheter in a Chest Vein for Feeding
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