Sometimes patients need a "central line" to be inserted through a vein to the vena cava (the largest vein which returns blood to the heart) to deliver or monitor fluids, blood or medications. This central line is a very thin, flexible plastic tube called a catheter, which is smaller in diameter than the vein it's inserted through.
Some, but not all IV (intravenous) lines are central lines. An IV is considered a central line when its end point is in the chest, meaning close to the heart, or in the right atrium of the heart.
Central lines may have names that may be more familiar to you such as "ports" or PICC lines (pronounced "PICK", peripherally inserted central catheter).
A central line infection really describes the way an infection is introduced to a patient, not the germ that becomes an infection.
In the hospital, central lines may introduce such infections as:
- MRSA
- VRE
- CRKP
- and others.
Since the catheter is inserted directly into the patient, it must be clean of any germs, and stay clean, or the patient can become infected. The CDC recommends very stringent steps be taken as a line is inserted to be sure it doesn't introduce a pathogen during insertion. There are also guidelines as to how quickly a central line must be removed or replaced, usually within 72 to 96 hours, depending on where on the body the line was inserted. These recommendations are different for children, depending on their age and weight.
Patients, providers and caregivers must be vigilant to keep the central line clean. Even those that are antiseptically clean when they are inserted can be colonized and introduce infections between the time they are inserted and the time they are removed.
As a patient, caregiver or advocate, you'll need to keep an eye on the care of any central line. Ask plenty of questions of any provider who is involved in the insertion, maintenance or removal of the line, or any of the fluids the line is set to deliver or monitor. If the central line has been inserted in the patient for longer than three to four days, ask how soon it will be removed or replaced.
Learn more about hospital acquired infections:
- General information about hospital acquired infections
- Methicillin-resistant staphylococcus aureus (MRSA)
- Clostridium difficile (C.Diff)
- Vancomycin-resistant enterococci (VRE)
- Carbapenem-resistant Klebsiella pneumoniae (CRKP)
- Necrotizing fasciitis, the flesh-eating bacterial disease
- Also - Central Line Infections - these are not superbugs, rather they are one mode of entry for these infectious agents.
- Sepsis and Septicemia of the blood
- Some advice about preventing hospital infections, too.
References:
Central Line Infections from the CDC
Definition of Central Line from MedTerms
