heart and blood vessel disorders
Central Venous Catheterization
Introduction
Central venous catheterization can be used to measure pressure in the large vein that returns blood to the heart from the upper part of the body. In central venous catheterization, a catheter is inserted into one of the large veins of the neck, upper chest, arm, or groin. This procedure is most often used to give intravenous fluids, solutions, or medications, particularly when a catheter cannot be inserted into an arm or a leg vein (peripheral intravenous catheter). Central venous catheterization is occasionally used to monitor central venous pressure (pressure in the superior vena cava, the large vein that returns blood to the heart from the upper part of the body). Central venous pressure reflects the pressure in the right atrium when it is filled with blood. This measurement helps doctors estimate whether the person is dehydrated and how well the heart is functioning. But it has largely been replaced by Pulmonary Artery Catheterization . Because central venous catheters are larger than a regular intravenous (IV) catheter and the veins in which they are placed are deeper, doctors usually inject a local anesthetic before doing the procedure. They also take precautions to prevent infection, such as covering the person with sterile drapes and wearing sterile gown and gloves. Serious complications are rare. Complications include inadvertently puncturing the artery that typically runs alongside large veins, bleeding, infection, and, for chest veins, puncturing the lung and causing a Pneumothorax . This figure shows the blood vessel (subclavian vein) in the chest that can be used for central venous catheterization. 