Central Venous Catheter

Definition

Large-bore intravenous catheter placed in a central vein (subclavian, jugular, or femoral) allowing safe delivery of hypertonic solutions for parenteral nutrition and medications. Required for TPN with osmolarity >900 mOsm/L.

How it works

Central venous catheters (CVCs) are essential for total parenteral nutrition because TPN solutions are hypertonic and would cause severe phlebitis and tissue damage if infused through peripheral veins. The catheter is typically inserted into the superior vena cava via the subclavian or internal jugular vein, where rapid blood flow dilutes the concentrated solution. Proper placement must be confirmed radiographically before use. While CVCs enable critical life support, they carry risks including infection (catheter-related bloodstream infection), thrombosis, and mechanical complications, requiring strict aseptic care and regular assessment.

Role

Provides safe access for administration of hypertonic parenteral nutrition and other medications that require central venous administration.

Examples

• PICC line (peripherally inserted central catheter)
• Hickman catheter for long-term support
• Temporary dual-lumen catheter in ICU
• Tunneled catheter for home TPN

Recommendations

Maintain strict aseptic technique during insertion and dressing changes. Use dedicated port for TPN only. Check position with chest X-ray before use. Remove as soon as central access is no longer needed. Monitor for signs of infection daily.

Key takeaway

Central venous catheters are indispensable for safe TPN delivery but require meticulous care to prevent serious complications.

Related terms