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A tunneled catheter is a catheter (a thin tube) that is placed in a vein for long-term use. It is most commonly placed in the neck (internal jugular) but may also be placed in the groin (femoral), liver (transhepatic), chest (subclavian) or back (translumbar). [3]
The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the posterior compartment of the jugular foramen, at the base of the skull.
Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
The most common complications are: catheter blockage (7.4%), and catheter-related infection (5.6%). Other complications are: malpositioning of the catheter, venous thrombosis, catheter leak or dislodgement. [3] The common carotid artery may be injured during the puncture of the internal jugular vein as the artery lies close to the vein.
The incidence of pneumothorax is highest with subclavian vein catheterization due to its anatomic proximity to the apex of the lung. In the case of catheterization of the internal jugular vein, the risk of pneumothorax is minimized by the use of ultrasound guidance. For experienced clinicians, the incidence of pneumothorax is about 1.5–3.1%
The jugular veins are veins that take blood from the head back to the heart via the superior vena cava. The internal jugular vein descends next to the internal carotid artery and continues posteriorly to the sternocleidomastoid muscle.
First described in 1975, [2] it is an alternative to central venous catheters in major veins such as the subclavian vein, the internal jugular vein or the femoral vein. Subclavian and jugular line placements may result in pneumothorax (air in the pleural space of lung), while PICC lines have no such issue because of the method of placement.
In some situations, venous access is obtained by inserting catheters into the large central veins of the trunk of the body such as the internal jugular, subclavian, or femoral veins. This type of venous access is performed with central venous catheters (CVCs) , and is required in certain situations where peripheral access is inadequate.