Central Lines

 

Children who have cancer will have many medication administered throughout their therapy.  Many of these medications need to be given through IV.  When the length of the treatment is long, a permanent venous access devise is often preferred.  This prevents the child from having repeated sticks (ouches) while allowing the doctor to give the needed treatment.

There are different types of devices that are used in children.  They are the following:

• Implantable Ports
• External Central Lines (single or double lines)

The type of venous access devise used depends on the child’s diagnosis and medications needed, as well as family preference.  The placement of a central venous device is done by a surgeon under anesthesia in the operating room.

 

Implantable Ports

• Description:
  Implantable ports have a long soft tube that is inserted into a large vein leading to the heart.  The other end leads into a small chamber called a port.  It is located under the skin, usually in the chest.

• Placing the Device:
  The port is placed surgically through a small incision in the chest area.  When the incision is closed, the port will be entirely under the skin.

• Accessing the Device:
  It is accessed by putting a special needle (Huber needle) through the skin into the port.  Although it requires a needle stick, a special cream (EMLA cream) is applied to the area 1 hour prior to accessing the port in order to numb the skin.

• Caring for the Device:
  When not in use, the port must be flushed monthly with heparin to prevent clotting.  When in use, the needle must be changed every 5 days.

• Advantages:
  Ports can be used to draw blood, give medications and transfuse blood products.  The catheter does not extend outside of the body.  Only a small bump is seen in the chest area.  Minimal care is needed.  Activities are not restricted, such as showers, swimming, and most sports.

• Disadvantages:
  A needle stick is required to access the port; special creams are available for numbing the site.

 

External Central Lines (Broviac, Hickman):

• Placing the Device:
  An external central line has a long, soft tube that is inserted into a large vein leading into the heart.  The catheter extends a few inches outside of the body, usually in the chest area.

• Accessing the Device:
  It is accessed by removing the cap at the end of the catheter.  Medications or other fluids can then be administered by placing a syringe or tubing to the end of the catheter.

• Caring for the Device:
  A central venous catheter must be flushed daily with heparin in order to prevent clotting.  The place where the catheter comes out of the skin requires cleaning three times a week.

• Advantages:
  Central venous catheter can be used to draw blood samples, give medications, and transfuse blood products.  No needle sticks.

• Disadvantage:
  It must be flushed with heparin daily and sterile dressing changes must be done 3 times a week.  A few inches of the catheter remains outside of the chest.  Some activities, such as contact sports, swimming, and showers are restricted.

*Information provided by Florida Hospital Cancer Institute

Last update Nov. 1, 2008