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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2021; 42(03): 276-278
DOI: 10.1055/s-0041-1732850
Trainees’ Corner

Central Venous Catheters in Oncology

Nitish Garg
1   Medical Oncology Resident, Vydehi Institute of Medical Sciences & Research Center, Bangalore, Karnataka, India
,
Rushabh Kothari
2   Department of Medical Oncology, canCURE Cancer Center, Narayana Multispeciality Hospital, Ahmedabad, Gujarat, India
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Treatment of major cancers requires intravenous administration of chemotherapy or supportive treatment like blood transfusions, antibiotics, antifungals, intravenous fluids, and parenteral nutrition for many months. Repeated venipuncture is needed for same. It is one of the pain points for patients that if addressed well makes the whole journey of treatment more tolerable and less anxious. If you ask any medical oncologist, he will agree that central venous catheter (CVC) is the lifeline of chemotherapy patients. The rationale for CVC is that repeated venipuncture is associated with damage to the tunica intima of the veins and this repeated trauma is associated with thrombophlebitis and thrombosis; with the use of CVC, the trauma is reduced and the substances are instilled directly into the larger lumen veins with thicker walls.[1]

There are mainly four types of central venous devices:

  1. Nontunneled CVC—Central lines and rigid dialysis catheters

  2. Tunneled CVC—traditional tunneled catheter, tunneled dialysis catheter, Hickmann catheter, and hybrid triple lumen tunneled catheter

  3. Implanted ports—Chemoports and arm ports

  4. Peripherally inserted central catheter (PICC)

When a patient is planned for CVC, he should be evaluated for the level of care required, the duration of treatment, and the lifestyle of the patient for selecting the device. The position of the device can vary based on above consideration of the patient and his daily activity. If he wants to go to work while on treatment, subclavian line for CVC or an implanted port can be of help. Femoral line should be avoided as it has high chances of infections and hampers the daily activity of a person. Any history of previous CVC placed and any allergy to the device material or any pacemakers and automatic implantable cardioverter-defibrillators should be documented. Lastly, the type of infusions and drugs to be used should help us in selecting the CVC.



Publication History

Article published online:
20 September 2021

© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

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