ABSTRACT
The major indications for a central venous line include: its use in monitoring the critically ill patient, the rapid administration of fluids, parenteral alimentation, extensively burned patients with no peripheral access, obesity, the patient with extremely small peripheral veins, and infusion of hyperosmolar solutions. The placement of a central venous catheter for parenteral nutrition is usually not an emergency procedure. The patient should therefore be well hydrated in order to provide adequate venous pressure to fill the vein. The needle is grasped with an instrument to prevent displacement. The patient is asked to exhale and hold his/her breath at which time the syringe is disconnected from the needle. A finger is placed over the needle opening to prevent bleeding or air embolism. Thrombosis of the SVC and its main tributaries can occur following long-term parenteral alimentation. The usual cause is malposition of the catheter and resultant phlebothrombosis and thrombophlebitis.
