Central Line

This article defines Central Lines (CLs) to make sure we use the same definition in

• Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)
• T17 - Central venous catheter (TISS Item)
• CVC placement, any location
• (legacy) T - Central Venous Catheter at 2300 (TISS Item)

Definition

• A CL is a #vascular access catheter that passes through or has a tip ending in one of the #great vessels.
• It may be used for infusion, blood sampling, or hemodynamic monitoring.
• It can be temporary, or long-term/permanent.

great vessel

• aorta
• pulmonary artery
• superior vena cava
• inferior vena cava
• brachiocephalic veins
• internal jugular veins
• subclavian veins
• external iliac veins
• common iliac veins
• femoral veins

vascular access catheter

• subclavian vein catheter
• internal jugular vein catheter
• PICC (Peripherally Inserted Central Catheter)
• Swan-Ganz (pulmonary artery) catheter -- note placement of this has its own code Swan-Ganz (Pulmonary Artery Flotation) Catheter placement
• Broviac
• Groshong
• Quinton
• Hickman
• ASHE catheter
• hemodialysis catheter (e.g. Vascath)
• implanted ports (e.g. Port-a-cath)
• central line introducer -- i.e. even if it does not have a central line in it
• introducer for a temporary pacing wire
• tunnelled line insertions in Interventional Radiology

Not counted as Central Lines:

• arterial catheters inserted into an artery
• ECMO - (ECMO, VV, ECMO, VA)
• IABP
• VAD; IMPELLA
• A-V fistula
• regular peripheral IVs
• Midline PICC -- since these do not end in a central vein, AND they have a much lower infection rate (ref:DG Maki, DM Kluger and CJ Crnich. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clinic Proceedings 81(9):1159-1171, 2006)
• any intravascular device that does not have a lumen (e.g. pacemaker wires)

Legacy

We also used to code QA Infection CLI.