Central Line Placement and At-Home Care

What is a central line or access port?

Surgeons at Children’s Hospital Colorado use a central line to give your child ongoing doses of medication, fluids or nutrients. A central line is a thin, soft tube (catheter) that is placed in a vein to deliver medication, fluids and nutrients directly into your child’s bloodstream. We use central lines for infants and children because they have small veins that are often difficult and painful to access. A central line or access port helps your child receive treatment with fewer needle sticks.

Is central line placement a common procedure?

Pediatric surgeons at Children’s Colorado place over 400 pediatric central lines and access ports every year.

Every member of your child’s care team is trained and experienced in treating kids. From our pediatric surgeons and nurses to our pediatric anesthesiologists, we have the knowledge to provide excellent care to your child.

We explain your child’s care in ways you both understand, so you know your choices, what’s happening and what to expect.

Why does my child need a central line or access port?

Your child may need or benefit from a central line for many reasons, including:

• Chemotherapy for cancer treatment
• Intravenous nutrition, when a child can’t absorb enough nutrition through the normal digestive process
• Long-term intravenous antibiotics (medicine given directly into a vein)
• Blood diseases, like hemophilia, that cause problems with blood clotting and require medicine to prevent bleeding
• Hemodialysis for kidney failure, a treatment that cleans a child’s blood (hemodialysis requires larger catheters that need special attention)

What can patients and families expect from a central line placement?

Receiving anesthesia

Our pediatric anesthesiologists give your child medicine to make them sleepy and prevent them from feeling anything during the procedure.

Finding the vein

During the procedure, your child’s surgeon uses either ultrasound or an X-ray, a needle and a small catheter designed for children. The surgeon locates the large vein that flows into the heart and makes a needle stick or incision.

We usually place the catheter or port in your child’s chest or neck, or sometimes in their arm.

Placing the catheter

We thread the catheter into the vein, with the tip ending just above the heart. One or two stitches keep the catheter in place. Depending on the type of access line your child receives, they may or may not have a tube exiting their body.

After the procedure

The central line, or access port, is ready to use right away. We send your child home the same day unless they need other treatments.

The area around the port may be tender for a few days. Your pediatric care team teaches you how to care for your child’s central line before you leave the hospital.

Types of vascular access devices

Pediatric surgeons at Children’s Colorado use three main types of devices to access your child’s veins. We recommend the best option for your child, based on:

• How long we need to use the access line
• How often we need to use the access line
• Your child’s unique network of veins (venous system)

External tunneled catheters

These devices allow us to use the access line for a long time, multiple times per week. We usually place this catheter in the neck or upper chest to access the large veins above the heart. The catheters exit the body in an area of skin near the underlying vein.

Implantable ports

Implantable ports work when your child needs a long-term access line, but we only use the line about once a week. They have two parts:

• A port goes under the skin and has a silicon top that we access with a special needle.
• A catheter goes under the skin and makes it easier for doctors to take blood samples for testing and to give them fluids or medications.

With an implantable port, your child can swim and take baths as they usually would.

Peripherally inserted central catheters (PICC)

We use PICC lines when your child needs the access line for a shorter period, multiple times per day. PICC lines are smaller, longer lines that are inserted into a peripheral vein, usually in the arm, and then carefully threaded into the central veins near the heart.