Short-term tunneling of centrally inserted central venous catheters without additional kits: A practical,safe,and emergency-applicable technique

Abstract

Background:

The placement of central venous catheter in the cervico-thoracic region (CICC) is often required in patients needing access to the bloodstream for medication administration or rapid volume replacement. However, the exit site of the catheter in the neck poses a high risk of infection, is uncomfortable for the patient, and is difficult for healthcare providers to manage. For centrally inserted central catheters (CICCs) designed for short-term use, tunneling to distance the exit site from the venipuncture site is not typically performed.

Aim:

The purpose of this article is to present a tunneling technique that allows the repositioning of the catheter exit site to the infraclavicular fossa using only the materials included in standard CICC kits.

Methods:

At the Vascular Access Unit of ASST Spedali Civili in Brescia, we developed a rapid tunneling technique for short-term CICCs that requires no additional materials beyond those in standard kits. This technique was applied to 250 patients requiring short-term central venous access, relocating the catheter exit site from the neck to the infraclavicular region.

Results:

In all 250 cases, the technique successfully relocated the catheter exit site to the infraclavicular region, providing a location that patients found more comfortable and that was easier for healthcare staff to manage.

Conclusions:

The proposed technique offers a valid alternative for the placement of short-term CICCs, even in critical or resource-limited settings where conventional tunneling equipment is unavailable. With proper precautions, this method can be implemented by any physician involved in device placement. Further investigation is needed to determine whether this procedure reduces catheter-related bloodstream infections (CRBSIs), though the technique’s design suggests this may be a potential benefit.