Central Venous Cathetrization

Definition:
Central venous line is large bore cannula that use to administer the large volume of fluid and medication.

Indications:
In open heart surgery.
Fluid replacement in Shock.
Total Parenteral Nutrition (TPN).
Administration of irritant medication.
Hemodialysis.
Aspiration of Air embolism.
Venous assessing during CPR.

Contra-Indications:
Thrombocytopenia (Platelet less than 40 thousand).
Increased PT, APTT, INR.

Site of Insertions:
Right & left Internal Jugular vein.
Right & left Subclavian vein.
Femoral vein.

Technique:
Seldinger technique.

CVP Line Pressure:
Normal CVP line Pressure is 6 to 12 cm of water.

CVP Increased in :
Fluid overload.
Pulmonary air embolisms.
Cardiac temponade.
pleural Infusion.
Hemothorax.
During Coughing.

CVP Decreased in :
In Hypovolemia/ Shock.
Vasodilators.

Material that Uses:
Small Needle 16-18 G.
Guide wire.
10cc syringe.
CVP line (Double, three lumen).
Hepranized flushed solution.
Lignocaine 1%.
Pyodine-iodine Sol.
Sterile Towels.
4 X 4 gauze sponge.
21 G needle to draw the Lignocaine.
Mask.
Gloves and gown.



Complications:

• Air Embolism.
• Thromboembolism.
• Cardiac Arrhythmia.
• Pneumothorax.
• Hemothorax.
• Cardiac perforation.
• Sepsis.
• Atrial Puncture.