A central line, also known as a central venous catheter, is a thin, long, flexible tube that serves as a long-term IV. The line passes through an opening in the skin and into a vein. It then travels through the vein until it reaches a spot just near or inside the heart.
With some types of central lines, 1 end of the line extends outside of the body. The part on the outside of the body has a connector. Other types of central lines, like a subcutaneous port, are located completely under the skin.
Your child may get a central line if they are seriously ill and need treatment for a long time. Your care team will tell you why your child needs a central line.
Types of central lines
A subcutaneous port is a central venous catheter located completely under the skin. Medicine is given through the port using a special needle called a Huber needle.
Your child will get fewer needle sticks for medicines, fluids, nutrition, blood products, or blood samples. Your child may still get some needle sticks because some blood tests must come directly from a vein.
Some medicines can irritate your child’s blood vessels. A central line is placed in a large vein with high blood flow so there is less irritation.
You can give medicines through a central line at home, making it easier for your child to continue therapy.
You may use the line to give medicines or nutrition with a syringe or IV bag.
You can give more than 1 medicine at a time with some types of lines.
The line can stay in place for months or longer.
The care team will remove your child’s line when it is no longer needed.
What to expect before central line placement
The procedure will take place in an interventional radiology or operating room. Depending on the medical centers’ policies, you may be able to stay with your child until it is time for the line to be placed.
Before line placement, your child may have to stop eating and drinking for several hours before the procedure. These are called fasting guidelines. Your care team may call them NPO instructions. Your child must follow these instructions if asked to do so.
Your child may be awake or asleep for the procedure. If your child is awake, the care team will numb the skin first to prevent pain. Some patients may get general anesthesia to help them sleep during the procedure.
Anesthesia and surgical procedures always have risks. Your care team will tell you the risks and benefits of getting a central line.
What to expect after central line placement
The following are expected after central line placement:
If your child has anesthesia, they may sleep for about 1 hour in a recovery room.
After recovery, you and your child can usually go home.
Your child may feel sore or stiff near the placement site.
There may be some bruising or drainage.
Your child may feel something pulling on the outside of their skin.
It may take several days for your child to feel comfortable with their line. Let your care team know about any pain or discomfort your child feels.
How to care for a central line
If your child is going home with the central line, your care team will teach you how to care for it. All primary family caregivers will receive training on caring for the line and when to call about concerns. Ask your care team about anything you do not understand.
Your child should not do activities that could damage the line, such as contact sports and rough play. They must not swim or get the site wet, as this can increase the risk of infection. Ask your care team what your child can and cannot do with a central line.
Watch for problems. This includes infections, leaking, blood clots, and movement of the line.
Always wash your hands before and after doing any line care.
Keep the central line site clean and dry.
Make sure the dressing is changed every 7 days or more often if needed.
Make sure your child bathes and changes clothing daily.
Change your child’s bed linens once a week, or more often if they are dirty.
Practice good oral care to reduce mouth bacteria, including brushing teeth twice a day.
Seek medical care right away at any sign of infection, such as pain, redness, swelling, or fever.
When to call your care team
Call your care team if you notice any of the following:
Redness, pain, warmth, or swelling at the central line site that gets worse or does not get better in 24 hours
Fluid, blood, or pus leaking from the central line site
Bleeding at the central line site that will not stop
Swelling in the face, neck, shoulder, chest, or arm on the side of the body where the central line is inserted
Fever of 100.4°F (38°C) or higher, or as directed by your care team
Chills, nausea, weakness, chest pain, shortness of breath, fast heartbeat, dizziness, or confusion
A blockage, leak, or trouble flushing the line
Questions to ask your care team
Why does my child need a central line?
How long will my child need a central line?
What can I expect before, during, and after getting a central line?
How often do I need to flush the line or perform other line care activities?
What supplies do I need?
What notes should I keep about line flushes and other care?
Can my child shower or bathe while they have a central line?
What activities should my child not do with a central line?
Are there any long-term effects of a central line?
How will I know if my child has an infection?
When should I call the care team?
Key points about central lines
The care team can give medicines, therapies, blood products, and fluids through a central line. Family caregivers may be trained to use and care for the central line at home.
There are 3 types of central lines: peripherally inserted central line (PICC), tunneled central line, and subcutaneous port.
Your child gets fewer needle sticks with a central line.
Central line problems may include infection, blood clots, leaking, or movement of the line.
If your child goes home with a central line, follow all home care instructions.
Contact your care team right away if you notice problems.
Your child may need a procedure to place a PICC line, also called a peripherally inserted central catheter. A PICC line allows medicines, nutrition, blood products, and fluids to be given into a large vein. Learn about PICC lines and how to care for them.
A tunneled central line is a central venous catheter that is tunneled under the skin. A central line allows medicines, nutrition, blood products, and fluids to be given into a large vein.
A subcutaneous (implanted) port is a central venous catheter located completely under the skin, usually in the chest. Medicine and other treatments are given through the port using a special needle, called a Huber needle.
