A review in emergency central venous catheterization

Abstract

Central venous catheterization is widely used in the emergency setting. This review aims to assess central venous catheterization from the perspectives of types of catheters, sites of insertion, and techniques. In emergency conditions, non-tunneled catheters are preferred because the technique for its insertion is not complicated and less time-consuming. The size of catheter depends on the purpose of catheterization. For example, a large bore catheter is needed for rapid infusion. The ideal catheterization site should bear fewer thromboses, lower infectious rate, and fewer mechanical complications. Thus the femoral vein should be avoided due to a high rate of colonization and thrombosis while the subclavian vein seems to exhibit fewer infectious complications compared with other sites. The ultrasound-guided technique increases the success rate of insertion while decreases the mechanical complications rate.

Keywords: Central catheterization; Central venous catheters; Vascular access devices.

Fig. 1

Diagram of infraclavicular approach for subclavian and jugular venous access (from Taylor RW, Palagiri AV. Central venous catheterization. Crit Care Med. 2007;35(5):1390–1396.).

Fig. 2

Diagram of central approach for femoral venous access (from Taylor RW, Palagiri AV. Central venous catheterization. Crit Care Med. 2007;35(5):1390–1396.).