Short-term CVADs are devices in situ for days and possibly longer if tunnelled. They are reviewed daily for continued need and removed as soon as they are no longer required.rr
Advantagesr |
Disadvantagesr |
- may be used for variety of purposes: administration of high volume, irritative, multiple incompatible solutions and medications, central venous pressure monitoring, blood sampling
- may be inserted for emergent insertions
- available in heparin or antimicrobial impregnated materials to reduce the risk of infection and thrombosis
- relatively easy to insert and remove if not tunnelled
- tunnelled – potential to reduce the risk of infection and dislodgementrr
- can be inserted and removed at bedside
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- short-term use
- can be associated with a higher risk of infections compared to other CVADs
- require weekly dressings
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Centrally inserted central venous catheters (CICCs)
Centrally inserted central catheters (CICCs) previously central venous catheters (CVCs) are short-term devices inserted via the veins in the neck or chest including the jugular, subclavian, or axillary veins.
Features include:
- single or multiple lumens allowing for the administration of multiple, high volume or concurrent incompatible solutions or medications
- non-tunnelled as the catheter enters the vein near the skin puncture site or tunnelled catheter where the skin exit site is a distance from the venepuncture site to facilitate optimal dressing and securement application
- coated, bonded or impregnated with heparin, antimicrobials, silver, antiseptic
CICC/CVC- with chlorhexidine (CHG) disc, subcutaneous and adhesive engineeded securement device (ESD) and bordered semipermeable dressing |
Tunnelled CICC/CVC- with CHG disc, subcutaneous and adhesive ESD and bordered semipermeable dressing |
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© E. Alexandrou 2020
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© E. Alexandrou 2020
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Femorally inserted central catheters (FICCs)
Femorally inserted central catheters (FICCs) are short-term CICCs inserted via the femoral vein. The catheter tip is located in the inferior vena cava above the level of the diaphragm.r
These catheters can have single or multiple lumens, and are also non-tunnelled or tunnelled for optimal dressing and securement application.
Tunnelled FICC – exit site tunnelled to mid thigh, with CHG disc, subcutaneous and adhesive ESD, and bordered semipermeable dressing |
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© E. Alexandrou 2020
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Apheresis-centrally inserted central catheters (A-CICCs)
Apheresis-CICCs are open, large bore catheters (10-18.5 Fr for adults and 6-8 Fr for paediatric patients) that tolerate high flow rates for: therapeutic procedures for treatment of chronic conditions, e.g. plasmapheresis, erythropheresis, photopheresis; and cellular collections (to produce a product), e.g. stem cells, lymphocytes, granulocytes.r
These catheters can have a single, double or triple lumen – the third lumen has a smaller diameter to allow for administration of medications or fluids.
Advantagesr |
Disadvantagesr |
- large bore permits reliable high blood flow rates
- longer dwell time if tunnelled cuffed catheter
- can be inserted at the bedside
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- short-term use for non-tunnelled catheter
- requires different locking solutions, specific volumes/concentrations
- made of rigid material- may impact patient comfort and securement may be challenging
- require weekly dressings and locking
- impact on body image
- patient discomfort
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Apheresis catheter – triple lumen, low internal jugular approach with CHG disc, subcutaneous and adhesive ESD, bordered transparent dressing |
Apheresis catheter – low internal jugular approach with CHG disc, adhesive ESD and bordered semipermeable dressing |
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© E. Alexandrou 2020
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© E. Alexandrou 2020
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