Childhood Cancer

Childhood Leukemia

Chapter 12: Central Venous Catheters

“Do what you can, with what you have, where you are.”

— Theodore Roosevelt

MOST CHILDREN WITH LEUKEMIA require intensive treatment, including chemotherapy, intravenous (IV) fluids, IV antibiotics, transfusions, frequent blood sampling, and sometimes IV nutrition. Central venous catheters provide a very effective way to allow entry into the large veins for intensive therapy. They eliminate the difficulty of finding veins for peripheral IVs (commonly just referred to as IVs) and allow drugs to be put directly into the bloodstream, where they are rapidly diluted and spread throughout the body. Most important, they reduce stress and discomfort for the child by getting rid of the need for hundreds of needle sticks.

The three most common types of central venous catheters are external catheters, subcutaneous ports, and peripherally inserted central catheters (PICC). Other names for a central venous catheter include venous access device, right atrial catheter, implanted catheter, indwelling catheter, central line, Hickman®, Broviac®, PORT-A-CATH®, and Medi-port®.

This chapter first describes external, implanted, and PICC catheters—what they look like, how they are placed, the care they need, and their risks. Because some institutions allow families to choose the type of catheter, a section is included about making a decision. The chapter ends with descriptions of the types of adhesives that can be used to secure the lines in place.