
The multiple indications for central venous catheters (CVCs) include parenteral nutrition, intravascular depletion, access for vasoactive medications, hemodynamic monitoring, cardiopulmonary arrest, difficult peripheral intravenous (IV) access and long-term IV access for medications, such as antibiotics. While these catheters can be life saving, they are also associated with significant risks.
Unsuccessful insertion of central venous catheters may occur in up to 20% of cases. The hazards associated with attempted central venous catheter insertion (whether successful or not) include arterial puncture, hematoma, pneumothorax, hemothorax, chylothorax, brachial plexus injury, arrhythmias, air embolus, catheter malposition and catheter knotting. Other complications associated with central venous catheters, such as infection, thrombosis, arterial-venous fistula and vascular or cardiac erosion, are not usually associated with needle insertion but occur after catheter placement.
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