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Central Venous Catheterization: A Comprehensive Review, Part I

Central venous catheterization is an indispensable tech nique in today's practice of medicine. It was initially used to monitor central venous pressure; however, this method has become obsolete. Central venous access is now more commonly established to administer hyper tonic intravenous alimentation or to insert pulmonary artery catheters. The sites available for central venous catheterization include the antecubital veins, external and internal jugular veins, subclavian vein, and femoral vein. Many of these sites offer more than one method of insertion. Although the indications for central venous access are well known, there is a general lack of respect for the considerable incidence of associated complica tions. It is useful to separate complications into two categories: those associated with venipuncture and catheter insertion, which will vary greatly depending on the route chosen, and those associated with catheter maintenance, which tend to be similar. The various methods of central venous catheterization are com prehensively reviewed with regard to specific indica tions, technique, and complications.