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Nontunneled Catheters
Anatoly Loskutov, MD; Brandt C. Wible, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Outcomes

          TERMINOLOGY

          • Synonyms

            • Temporary central venous catheter
            • Temporary dialysis catheter
            • Central venous catheter
          • Definitions

            • Nontunneled catheter: Short-term central venous catheter placed percutaneously into central veins of chest/abdomen
              • Catheter of choice in management of acute medical conditions
              • Typical dwell time of days to weeks
              • Not appropriate for outpatient setting
            • Types of nontunneled catheters
              • End-hole catheter
                • Most common type
                • Tip may be trimmed to required length
              • Staggered-tip catheter
                • Designed to allow simultaneous aspiration/infusion with minimal mixing
                  • Typical use is for temporary hemodialysis or plasmapheresis
                  • Cannot trim tip
              • Valve-tip catheter
                • Valve opens inward for aspiration/outward for infusion
                  • Cannot trim tip
                  • Adaptor allows external portion of catheter to be trimmed to appropriate length

          PREPROCEDURE

          • Indications

            • Contraindications

              • Preprocedure Imaging

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Procedure Steps

                      • Alternative Procedures/Therapies

                        POST PROCEDURE

                        • Expected Outcome

                          • Things to Do

                            • Things to Avoid

                              • Management of Nontunneled Catheter-Specific Complications

                                OUTCOMES

                                • Complications

                                  • Expected Outcomes

                                    Selected References

                                    1. Ibeas-Lopez J: New technology: heparin and antimicrobial-coated catheters. J Vasc Access. 16 Suppl 9:S48-53, 2015
                                    2. Patel IJ et al: Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 23(6):727-36, 2012
                                    3. Bhutta ST et al: Evaluation and management of central venous access complications. Tech Vasc Interv Radiol. 14(4):217-24, 2011
                                    4. Chung HY et al: Principles of non-tunneled central venous access. Tech Vasc Interv Radiol. 14(4):186-91, 2011
                                    5. Nakae H et al: Catheter-related infections via temporary vascular access catheters: a randomized prospective study. Artif Organs. 34(3):E72-6, 2010
                                    6. Worth LJ et al: Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices. Support Care Cancer. 17(7):811-8, 2009
                                    7. Ausserhofer D et al: [Care of the non-tunneled central venous catheter. Literature search on disinfectants, dressings and intervals between dressing changes.] Pflege Z. 61(8):457-62, 2008
                                    8. Castelli GP et al: Central venous catheter replacement in the ICU: new site versus guidewire exchange. Minerva Anestesiol. 73(5):267-73, 2007
                                    9. Chiou PF et al: Antibiotic lock technique reduces the incidence of temporary catheter-related infections. Clin Nephrol. 65(6):419-22, 2006
                                    10. Maki DG et al: The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 81(9):1159-71, 2006
                                    11. Warren DK et al: A multicenter intervention to prevent catheter-associated bloodstream infections. Infect Control Hosp Epidemiol. 27(7):662-9, 2006
                                    12. Ponikvar R et al: Temporary hemodialysis catheters as a long-term vascular access in chronic hemodialysis patients. Ther Apher Dial. 9(3):250-3, 2005
                                    13. Abdelkefi A et al: [Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective study about 210 cases.] Ann Fr Anesth Reanim. 22(9):773-7, 2003
                                    14. Cicconi S et al: Non-tunneled central venous catheters in adult stem cell transplantation recipients: An effective option. J Vasc Access. 2(4):168-74, 2001
                                    15. Abidi SM et al: Factors influencing function of temporary dialysis catheters. Clin Nephrol. 53(3):199-205, 2000
                                    16. Oliver MJ et al: Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study. Kidney Int. 58(6):2543-5, 2000
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Preprocedure

                                        • Procedure

                                          • Outcomes

                                            TERMINOLOGY

                                            • Synonyms

                                              • Temporary central venous catheter
                                              • Temporary dialysis catheter
                                              • Central venous catheter
                                            • Definitions

                                              • Nontunneled catheter: Short-term central venous catheter placed percutaneously into central veins of chest/abdomen
                                                • Catheter of choice in management of acute medical conditions
                                                • Typical dwell time of days to weeks
                                                • Not appropriate for outpatient setting
                                              • Types of nontunneled catheters
                                                • End-hole catheter
                                                  • Most common type
                                                  • Tip may be trimmed to required length
                                                • Staggered-tip catheter
                                                  • Designed to allow simultaneous aspiration/infusion with minimal mixing
                                                    • Typical use is for temporary hemodialysis or plasmapheresis
                                                    • Cannot trim tip
                                                • Valve-tip catheter
                                                  • Valve opens inward for aspiration/outward for infusion
                                                    • Cannot trim tip
                                                    • Adaptor allows external portion of catheter to be trimmed to appropriate length

                                            PREPROCEDURE

                                            • Indications

                                              • Contraindications

                                                • Preprocedure Imaging

                                                  • Getting Started

                                                    PROCEDURE

                                                    • Patient Position/Location

                                                      • Procedure Steps

                                                        • Alternative Procedures/Therapies

                                                          POST PROCEDURE

                                                          • Expected Outcome

                                                            • Things to Do

                                                              • Things to Avoid

                                                                • Management of Nontunneled Catheter-Specific Complications

                                                                  OUTCOMES

                                                                  • Complications

                                                                    • Expected Outcomes

                                                                      Selected References

                                                                      1. Ibeas-Lopez J: New technology: heparin and antimicrobial-coated catheters. J Vasc Access. 16 Suppl 9:S48-53, 2015
                                                                      2. Patel IJ et al: Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 23(6):727-36, 2012
                                                                      3. Bhutta ST et al: Evaluation and management of central venous access complications. Tech Vasc Interv Radiol. 14(4):217-24, 2011
                                                                      4. Chung HY et al: Principles of non-tunneled central venous access. Tech Vasc Interv Radiol. 14(4):186-91, 2011
                                                                      5. Nakae H et al: Catheter-related infections via temporary vascular access catheters: a randomized prospective study. Artif Organs. 34(3):E72-6, 2010
                                                                      6. Worth LJ et al: Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices. Support Care Cancer. 17(7):811-8, 2009
                                                                      7. Ausserhofer D et al: [Care of the non-tunneled central venous catheter. Literature search on disinfectants, dressings and intervals between dressing changes.] Pflege Z. 61(8):457-62, 2008
                                                                      8. Castelli GP et al: Central venous catheter replacement in the ICU: new site versus guidewire exchange. Minerva Anestesiol. 73(5):267-73, 2007
                                                                      9. Chiou PF et al: Antibiotic lock technique reduces the incidence of temporary catheter-related infections. Clin Nephrol. 65(6):419-22, 2006
                                                                      10. Maki DG et al: The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 81(9):1159-71, 2006
                                                                      11. Warren DK et al: A multicenter intervention to prevent catheter-associated bloodstream infections. Infect Control Hosp Epidemiol. 27(7):662-9, 2006
                                                                      12. Ponikvar R et al: Temporary hemodialysis catheters as a long-term vascular access in chronic hemodialysis patients. Ther Apher Dial. 9(3):250-3, 2005
                                                                      13. Abdelkefi A et al: [Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective study about 210 cases.] Ann Fr Anesth Reanim. 22(9):773-7, 2003
                                                                      14. Cicconi S et al: Non-tunneled central venous catheters in adult stem cell transplantation recipients: An effective option. J Vasc Access. 2(4):168-74, 2001
                                                                      15. Abidi SM et al: Factors influencing function of temporary dialysis catheters. Clin Nephrol. 53(3):199-205, 2000
                                                                      16. Oliver MJ et al: Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study. Kidney Int. 58(6):2543-5, 2000