Central Venous Line (Catheter) Complications

It is rare for children to have problems from central venous line placement surgery. But all anesthesia and surgery have risks. Some complications of central line placement may include:

• Injury to a blood vessel
• Lung injury
• Blood clots
• Heartbeat that is not regular
• Nerve injury
• Infection

There are other possible complications when your child has a central venous line:

• The vein may get swollen and irritated.
• Your child may get an infection in or around the line.
• The catheter could get blocked.
• The catheter may move out of place.Blood clots may form in the catheter or in the vein.

The care team will talk with you about these risks and how to prevent them. They will treat problems if they happen.

The sooner you report problems, the better. Ask your health care team if you have questions or concerns.

Central line–associated bloodstream infection (CLABSI)

Bacteria (germs) may cause a blood infection if your child has a line. This type of infection is known as a central line–associated bloodstream infection (CLABSI). Bacteria can live on:

• Hands
• Skin
• Connectors
• Other items used for patient care and daily activities

Bacteria can enter the body different ways. They may come through a cut in the skin where the line enters the body or through the line itself.

Central venous line infection prevention

Your care team will show you how to take care of your child's central venous line. You will practice with the team while your child is in the hospital.

It is normal to be afraid when you start learning. You will get more comfortable doing this with time. Line care will become part of your routine.

Carefully follow all the steps you learn in training so that you do not spread germs.

• Only trained people should do line care.
• Follow the care steps exactly as the team taught you.
• Always wash your hands or use hand sanitizer before starting line care. Handwashing helps prevent infection.
• Keep the dressing clean, dry, and stuck to the skin.
• If the dressing gets loose, wet, or dirty, call your care team so it can be changed right away.
• Follow your care team’s instructions on how to keep the dressing dry for a bath or shower.
• Do not put a dressing under water. No swimming.
• Keep the line secure so it does not move.
• Do not let the tube from the line hang in the diaper area. where there are more germs.
• If your child may drool or vomit, protect the dressing with a bib or other item worn on the outside of clothing .
• Never use scissors, hemostats, or other sharp objects near the line tubing.

Watch your child carefully for infection. If you delay getting treatment for your child, the infection can get worse. It can even be life-threatening. If you notice fever and signs of infection, call your care team right away. They can check your child for infection and provide treatment if needed.

Watch for signs of infection

Watch your child carefully for signs of infection. Depending on your child’s age or other factors, they may not be able to tell you how they feel.

Look for symptoms and behavior changes. Contact your clinic right away if you notice changes. If you wait too long, germs will continue to grow, and the infection will be harder to treat.

Watch for a central line blockage (occlusion) 

• There might be a blockage in the line if it is hard to flush with a syringe. If it seems hard to flush, do not force it. Stop and contact your doctor.
• Check the line for kinks that might stop liquids from going in.
• Make sure the line is unclamped.
• If your child has a pump attached to the line, it may not be working.
• If the block is from a blood clot, your care team might give your child medicine to clear the blockage.

Contact your care team if you notice any signs of blockage.

Watch for signs of central line damage and movement

If your child has a central line, do not tug or pull on it. If your child has a port, do not put pressure on it. Keep the line secure.

The line may have moved if:

• It seems blocked
• The nurse cannot get a blood sample from it
• It hurts or feels uncomfortable in your child's arm, shoulder, jaw, chest, or head when medicines or fluids go in
• The tube that is outside of the body looks longer than usual

If you think that your child’s line has moved or looks longer, call your child’s care team or the Infusion Center.

You can use your “Central Line Urgent Care Kit” if the line is damaged or comes out.

If you see a crack, a hole, or a cut in the line:

1. Clamp the line above the hole.
2. Clean the damaged area with an alcohol pad.
3. Wrap the area with sterile gauze.
4. Use tape to hold the gauze in place.
5. Call your clinic.

If your child has a tunneled central line that comes out:

1. If possible, have your child lay flat on their back.
2. Find the insertion site (small scar near your child’s neck). Put pressure on it for 5 minutes.
3. Cover the place where the line comes out of your child’s body (exit site) with sterile gauze.
4. Use tape to hold the gauze in place.
5. Call your clinic.
6. Do not throw the line away. Save it and bring it with you to the hospital.

Watch for signs of blood clots

Blood clots stop blood flow to a part of the body. The symptoms of a blood clot can vary, depending on where the clot is.

Contact your child’s care team or the Infusion Center if you notice:

• Shortness of breath
• Pain, swelling, or redness near the line areas such as in the neck, shoulder, arm, or chest

Learn more about blood clot causes and treatment.

For more information

Learn more about central venous catheters and related topics at together.stjude.org.