Central venous catheters

#### Summary points Central venous catheterisation was first performed in 1929 when Werner Frossman, a German doctor, inserted a ureteric catheter into his antecubital vein. He then walked to the radiography department so that the catheter could be guided into his right ventricle using fluoroscopy. Since then, central venous access has become a mainstay of modern clinical practice. An estimated 200 000 central venous catheters were inserted in the United Kingdom in 1994,1 and the figure is probably even higher today. Clinicians from most medical disciplines will encounter patients with these catheters. Despite the benefits of central venous lines to patients and clinicians, more than 15% of patients will have a catheter related complication.2 This review will provide an overview of central venous catheters and insertion techniques, and it will consider the prevention and management of common complications. #### Sources and selection criteria We searched the Cochrane Database of Systematic Reviews, Medline, Embase, and Clinical Evidence online. Search terms included central venous catheter, peripherally inserted central catheter, and complication. The reference lists of relevant studies were hand searched to identify other studies of interest. We also consulted relevant reports and national guidelines. A central venous catheter is a catheter with a tip that lies within the proximal third of the superior vena cava, the right atrium, or the inferior vena cava. Catheters can be inserted through a peripheral vein or a proximal central vein, most commonly the internal jugular, subclavian, or femoral vein. …