A central line is a permanent IV that leads directly to the heart, to allow the administration of TPN and meds that would normally be caustic to veins.
See Central lines and TPN for tips and tricks.
There are many different kinds of central lines:
- Broviac, Hickman, and Groshong: These are usually placed in the upper chest, but sometimes in the femoral vein in the groin. The catheter comes out several inches from the body. These are apparently less infection-prone than ports, and if infected, the infection can often be taken care of without removing the line.
You may also face a decision of how many lumens to get in your central line (single, double, multiple). More lumens may increase the risk of infection, suggesting it is best to go with as few lumens as possible. The number you need depends on what you are infusing. If you are infusing 2 compatible solutions (e.g., TPN and fluids), these can be run through a single lumen via a bi-fuse or y. Three compatible solutions can be run through a tri-fuse. More than one lumen is useful if you consistently need to infuse incompatible solutions (e.g., meds).
- Port: These are placed entirely under the skin, usually in the upper chest area.
They seem to be favored in patients who swim and who do not need to be accessed that often (and who are not infection-prone), because accessing ports requires a skin puncture (while accessing the other types of lines does not) but they involve fewer restrictions on swimming.
- PICC (Peripherally Inserted Central Catheter): These are usually placed in the arm, with the catheter coming out several inches from the skin. They are designed to be used for weeks to months (whereas the options above may last for years), but some families have used them for over a year.
DEHP-free tubing is recommended for infusion sets and g-tube tubing. Discussion of this topic on the yahoo short bowel syndrome group in March 2008 suggested that some infusion companies have changed to DEHP-free products across the board, and that DEHP-containing products may no longer even be made. DEHP-free tubing may be marked "DEHP-free" or have "DEHP" with a circle and line through it.