CVC care

Central venous catheter

The central venous catheter, a special type of intravenous catheter (tube), is indispensable in today’s dialysis centres. Some patients start haemodialysis without permanent vascular access – they will most often have a central venous catheter (CVC).

Why do you need a CVC

If a patient’s blood vessels are damaged or very fragile, it is not possible to create a fistula. And because access is so fast, CVCs are also used for emergency treatment. If a central venous catheter is the best choice for your haemodialysis treatment, a physician or surgeon will insert it into a central vein – a jugular vein (neck), a subclavian vein (chest), or a femoral vein (groin).

Central venous catheters offer immediate access to the blood system. Patients with CVCs may appreciate that they can move their arms and hands freely during dialysis, and that needle sticks are avoided. However, a long-term complication of catheters – especially those placed in the subclavian vein – is that the blood vessel often becomes abnormally narrow (stenosis). CVCs also pose a higher risk for infection, and patients have to be careful with their daily hygiene or if their leisure activities include swimming or bathing. Sometimes, a CVC makes it hard to obtain high blood flows, which may affect the efficacy of toxin removal.

CVC care

CVC care is usually done by nurses. The catheter exit site should be cleaned during each dialysis treatment. Personal protective equipment must be worn by the nurse. The patient should wear a mask while the dressing is changed and at any time the catheter is opened, such as during the connection and disconnection procedures. The sutures for non-tunnelled catheters must remain in place for as long as the catheter is inserted. If you have a tunnelled catheter, the sutures should be removed once the catheter cuff has healed into place.