Central Venous Catheters
Cancer treatment usually includes a variety of injections, blood draws, and intravenous medications and fluids. To make the process easier, many pediatric cancer patients have a catheter (a thin, flexible plastic tube) placed under the skin to allow access to a vein.
In the first few days of treatment, a patient may have a peripheral intravenous (IV) line (PIV) placed for temporary use. A peripheral IV is a small, short catheter commonly inserted in a vein in the hand or inside of the arm near the elbow. This type of IV catheter is for short-term use and must be replaced within a few days. In addition, due to the small size of the vein, some medications cannot be given through a peripheral IV.
A central venous catheter can be used to take blood samples, administer chemotherapy, give fluids and electrolytes, provide parenteral nutrition, and give antibiotics and other medicines. This illustration shows an example of a subcutaneous port.
During treatment for childhood cancer, an intravenous catheter may be placed in a large vein that leads to the heart. This type of catheter is a central venous catheter (often called a “central line”). A central venous catheter may be used to give medicines, fluids, blood products, and nutrition. Some blood samples can also be taken through a central venous catheter. A central venous catheter reduces the need for needle sticks which can be a source of discomfort and anxiety for patients and families. The central venous catheter can often stay in place for the duration of treatment (months to years). If infection or other complication occurs, the device will be removed and replaced as needed.
Uses of a central venous catheter:
- Take blood samples
- Administer chemotherapy
- Give fluids and electrolytes
- Provide parenteral nutrition
- Give antibiotics and other medicines
Types of Central Venous Catheters
There are 3 main types of central venous catheters used in pediatric cancer patients:
- Peripherally Inserted Central Catheter (PICC line)
- Tunneled Central Line
- Subcutaneous Port
A subcutaneous or “sub q” port is a central venous catheter located completely under the skin. Medicine is given through the port using a Huber needle.
Types of central venous catheters vary based on where they are placed and how they are used. Several factors determine what type of catheter is best for each patient. These include:
- Type and number of medicines and other treatments
- Duration of treatment
- Frequency of use
- Intensity of therapy
- Child’s age, size, and health status
- Child’s activity level
- How much care is needed to maintain the catheter
- Risk of infection and other complications
A doctor will explain the details of the procedure and discuss the risk and benefits. One of the biggest risks of a central venous catheter is infection. It is important to follow all line care instructions to reduce risk of infection and keep the line working properly.
—
Reviewed: June 2018