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Long-Term Intravenous Catheters
(Non-Hemodialysis) The
improvement in antibiotic and chemotherapy, intravenous feedings (hyperalimentation)
combined with the increase in outpatient therapy for a variety of diseases has produced a
need for long term intravenous access. What
is Long Term Intravenous Access (Catheters)? Long
term IV access is required when a particular treatment (intravenous antibiotics for
infection, chemotherapy for cancer treatment, for example) will be ongoing for a prolonged
period of time (usually more than 3-4 weeks). The use of these different access devices
obviates the need for insertion of an intravenous catheter every 3-5 days. These long-term
devices are designed to withstand infection and remain functional when placed properly. Where
Are These Catheters Inserted? The
tip of the catheter is placed into one of the large veins near the heart. This allows for
high rates of blood flow, which permit the delivery of concentrated solutions that may be
caustic to smaller veins. Additionally, the locations of these catheters reduce the chance
of clotting in the vein into which they are inserted. Centrally placed catheters can be
used for blood drawing, if appropriate procedures are utilized. How
Are These Catheters Inserted? Generally,
the catheters are inserted via a needle that enters a large vein under the collarbone or
in the neck. Local anesthesia is used and the entire procedure takes approximately 15
minutes to complete. While not mandatory, most of these procedures are performed in the
operating room to allow for sterile conditions, excellent lighting and appropriate
monitoring of the patient by an anesthesiologist. The use of the neck or upper chest area
allows the arms of the patient to be free and unencumbered by peripherally (in the arms)
inserted catheters. Are
There Different Types of These Catheters? Most
definitely! While there are many different types of catheters, they can generally be
divided into two types; those that are completely underneath the skin and those that have
a portion of the catheter exposed. The catheters that are completely underneath the skin
required a needle to be inserted, through the skin, into the ``port" in order to
infuse intravenous solutions or withdraw blood. These types of catheters generally require
little maintenance other than ``flushing" the intravenous line after its use.
Catheters that emerge from the skin are easier to utilize since the area to access it is
visible; however, these must be carefully tended to, in order to avoid infection or other
problems with the catheter. What
Type of Long Term Intravenous Catheters Is Best for Me? That
decision is best left to the surgeon and physician whose care you are under. Certain
situations mandate the use of one type of catheter while specific patient characteristics
(body habitus, underlying disease process or lifestyle) may warrant the use of another
type of catheter. How
Often Must The Catheters Be Replaced? The
frequency with which they are used and the care given to the catheter when it is accessed
determines the longevity of the catheter. Catheters may be left in place indefinitely if
they are functioning well and have no signs of infection. Once infection of the catheter
is detected, however, it usually must be removed to eradicate the infectious process.
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