Central venous catheters (CVCs)

Central venous catheters are typically inserted at the neck (right or left interior jugular vein), upper chest (subclavian vein), or the groin (femoral vein). They are meant to be temporary catheters and should be exchanged or replaced at least once every 14 to 21 days to reduce the risk of bacteremia and soft tissue infection.

Single lumen CVC

Single Lumen

The single lumen CVC is seldom used because it only has a single lumen.

Dual lumen CVC

The dual lumen CVC is seldom used because it only has two lumens. It looks like the triple lumen, except it only has two ports.

Triple lumen CVC

Triple Lumen

The triple lumen CVC is commonly used in the ICU. It has three lumens, which make it practical in the ICU.

Quad lumen CVC

The quad lumen CVC looks like the triple lumen, except it has four ports and it looks chubbier.

Peripherally inserted central catheter (PICC)

PICC lines are typically inserted into the arm proximal to the antecubital fossa. They are usually 40 to 60 cm long and traverse inside the vein to reach the superior vena cava. PICC lines are commonly used when the patient has poor peripheral IV access, or when longer-term intravenous access is required, such as in the case of IV antibiotic treatment that lasts several weeks.

Tunneled catheters

Tunneled catheters are intended for long-term use. With proper care they can last for several months. They are typically used for hemodialysis and chemotherapy.

  • Hickman(R)
  • Broviac(R)
  • Perm-Cath(R)

Dialysis catheters

Niagara

Niagara

The Niagara is a common dialysis catheter. It is typically inserted into the neck. The larger bore allows for intermittent “real” hemodialysis and CRRT (i.e. CVVHD, continuous veno-venous hemodialysis). Different lengths, from 12.5 cm to 20 cm (as shown above), exists to accommodate different body sizes and line placement. Basically, if the Niagara is to be inserted into the patient’s right neck, the shorter version (e.g. 12.5 cm) should be used, otherwise the black tip will be poking the patient’s atrium or ventricle, and this can potentially damage the AV valve and cause arrhythmias.

Special catheters

Swan Ganz (pulmonary artery) catheter

Swan Ganz

Use of the Swan Ganz has fallen out of favour in recent years. This catheter is inserted into the right internal jugular and traverses through the right atrium (RA), right ventricle (RV), pulmonary trunk and ultimately pulmonary arteriole. Because of this, it is able to transduce simultaneously the pressures in the RA, RV, PA, and the pulmonary “wedge” pressure.

Cortis line

The Cortis line is a very thick and short central line inserted into the neck that can facilitate passage of smaller catheters such as a PA catheter, a triple lumen, and even pacemaker leads. A Cortis line enables the transfusion of large quantities of fluids within a very short amount of time. With a Cortis, one can transfuse a unit of blood or a litre of saline in seconds in an emergency situation. Nicknames include “the dilator” and “the king of lines”.