TABLE 1.

Catheters Used for Venous and Arterial Access

Catheter TypeEntry SiteLengthComments
Peripheral venous catheters (short)Usually inserted in veins of forearm or hand<3 inPhlebitis with prolonged use; rarely associated with bloodstream infection
Peripheral arterial cathetersUsually inserted in radial artery; can be placed in femoral, axillary, brachial, posterior tibial arteries<3 inLow infection risk; rarely associated with bloodstream infection
Midline cathetersInserted via the antecubital fossa into the proximal basilic or cephalic veins; does not enter central veins3–8 inAnaphylactoid reactions have been reported with catheters made of elastomeric hydrogel; lower rates of phlebitis than short peripheral catheters
Nontunneled CVCsPercutaneously inserted into central veins (subclavian, internal jugular, or femoral)8 cm or longer, depending on patient sizeAccount for majority of CRBSI
Pulmonary artery cathetersInserted through a Teflon introducer in a central vein (subclavian, internal jugular, or femoral)30 cm or longer, depending on patient sizeUsually heparin bonded; similar rates of bloodstream infection as CVC; subclavian site preferred to reduce infection risk
PICCsInserted into basilic, cephalic, or brachial veins and enter the superior vena cava20 cm or longer, depending on patient sizeLower rate of infection than nontunneled CVCs
Tunneled CVCsImplanted into subclavian, internal jugular, or femoral veins8 cm or longer, depending on patient sizeCuff inhibits migration of organisms into catheter tract, lower rate of infection than nontunneled CVC
Totally implantableTunneled beneath skin and have devices subcutaneous port accessed with a needle; implanted in subclavian or internal jugular vein8 cm or longer, depending on patient sizeLowest risk for CRBSI; improved patient self-image; no need for local catheter site care; surgery required for catheter removal
Umbilical cathetersInserted into either umbilical vein or umbilical artery6 cm or less, depending on patient sizeRisk for CRBSI similar to catheters placed in umbilical vein versus artery