Short-term CVADs are devices in situ for a minimum period of 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 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) or central venous catheters (CVCs)
Centrally inserted central catheters (CICCs) or 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 of these catheters include:
- single or multiple lumens allowing for the administration of multiple, high volume or concurrent incompatible solutions or medications
- non-tunnelled so the catheter enters the vein near the skin puncture site or tunnelled catheter where the skin exit site is a distance from the venepuncture for optimal dressing and securement application
- coated, bonded or impregnated with heparin, antimicrobials, silver, antiseptic
CICC/CVC- with chlorhexidine (CHG) disc, subcutaneous and adhesive external 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/CVCs inserted via the femoral vein. The catheter tip is located in the inferior vena cava.r
These catheters can have single or multiple lumens, and are non-tunnelled or tunnelled for optimal dressing and securement application.
The femoral veins should be avoided for planned insertions due to the risk of infection and thrombosis.rrrr
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 catheters
Apheresis catheters 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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