The following are the major indications for the use of central venous catheters:
🔸️Difficult peripheral venous access – central venous catheters may be placed when it is difficult to gain or maintain venous access peripherally (e.g. obesity, scarred veins from prior cannulations, agitated patient).D
🔸️Delivery of certain medications or fluids – medications such as vasopressors (e.g., norepinephrine, vasopressin, phenylephrine etc.), chemotherapeutic agents, or hypertonic solutions are damaging to peripheral veins and often require placement of a central line. Additionally, catheters with multiple lumens can facilitate the delivery of several parenteral medications simultaneously.
🔸️Prolonged intravenous therapies – parenteral medications that must be delivered for extended periods of time (more than a few days) such as long-term parenteral nutrition, or intravenous antibiotics are administered through a central line.
🔸️Specialized treatment – interventions such as hemodialysis, plasmapheresis, transvenous cardiac pacing, and invasive hemodynamic monitoring (e.g. pulmonary artery catheterization) require central venous access
🔴There are no absolute contraindications to the use of central venous catheters. Relative contraindications include: coagulopathy, trauma or local infection at the placement site, or suspected proximal vascular injury.
Source: Marino's, The ICU Book, 4th Ed
