Pediatric Tunneled Central Venous Catheter

Tunneled central lines are used when we need access to a vein over a long period of time (anywhere from two weeks to several months). Some medications can't be given through regular IV lines and require frequent, painful needle insertions. A tunneled central line is a more comfortable way for the patient to receive medications such as chemotherapy, nutrition and fluids, and also allows the medical team to obtain blood samples without placing a new IV. Larger tunneled CVCs can also be used for hemodialysis or long-term treatments like blood exchange or ECP.

Using ultrasound and live X-ray (fluoroscopy) for guidance, your child's doctor will insert the catheter into a vein, usually in the neck, and thread it into the large vein that carries blood into the heart. The other end of the catheter is tunneled under the skin and exits from the chest. The Interventional Radiology team at Children's National Hospital will always use the least amount of radiation as possible. 

No. The procedure will be performed with IV sedation or general anesthesia.

After the procedure, some children may feel mild discomfort around the site for several days.

One hour. 

This procedure is considered low risk. However, potential complications include:

• Bleeding
• Infections
• Puncture of adjacent structures (such as veins, arteries or nerves)
• Lung puncture (pneumothorax)
• Catheter breakage (when it is being removed) 
• Allergic reaction 

Your child will have two bandages, one over the insertion site (usually at the neck), and one over the catheter at the exit site (usually on the chest). After 48 hours, you may remove part of the bandage on the neck. The Dermabond^©, which is the blue glue on the incision, will come off by itself in one to two weeks. Do not pick it off. 

The bandage over the catheter must remain clean and dry at all times. It should be changed once a week. The bandage may be changed at appointments or family members may change it at home if they have been trained to do so. Do not remove the bandage if you have not been trained. 

Your child shouldn't take a shower or bath for 48 hours, until you have removed the bandage on the neck. After that, your child may shower or bathe with the catheter site bandage in place and covered. The dressing and catheter should remain dry. If showering, your child should face away from the spray so water does not hit the catheter directly. The catheter and insertion site should never be submerged under water.

After the tunneled central line is inserted, your child will be able to resume most activities, including day care or school. Your child should be discouraged from activities, such as contact sports and rough playing, which may result in a pull to the line and lead to damage or loss of the catheter. If you have questions about which activities are okay, please ask your child's doctor.

The procedure is performed with IV sedation or general anesthesia. Local numbing medicine will be injected into the skin around the catheter exit site (usually on the chest). The tissue will be loosened from the skin and the catheter removed. 

The bandaged must stay in place for 48 hours. Then, you may remove the bandage. Once the incision has healed, there is no need to place any type of dressing or covering over the site. 

Your child shouldn't take a shower or bath for 48 hours. After 48 hours, your child can shower or bathe normally.