What Is a Central Venous Catheter (Central Line)?

A standard IV in the hand or arm works well for a lot of hospital care — but not for everything. Some medicines are too strong for small veins, some treatments run for days or weeks, and sometimes a care team needs to measure pressures close to the heart or draw blood again and again without repeated needle sticks. That's the gap a central venous catheter fills.

A central line is a thin, flexible tube placed into a large vein — most often in the neck, the upper chest, or the groin — and advanced until its tip sits in a large central vein near the heart. Because the tip ends in fast-flowing central blood, medicines and fluids spread quickly, and the line can usually stay in place longer than a standard IV.

The video at the top of this page, "Central Venous Catheter Placement CVP & Pulmonary Artery Catheter", runs a little over fourteen minutes and follows central venous catheter placement as its subject, including the related pulmonary artery catheter named in its title. If you're about to have a line placed — or you're watching a family member's care — it gives you a grounded sense of what the procedure room, the sterile drapes, and the equipment actually look like.

Placing the line, step by step

Here's how placement usually unfolds. You'll lie flat, sometimes with the head of the bed tilted slightly down, and the team will position you so the chosen vein is as accessible as possible. The skin over the site is cleaned thoroughly, you're covered with sterile drapes, and the clinician wears sterile gloves, a gown, a mask, and a cap — that full barrier setup is deliberate, because keeping the line sterile from the very first minute is the main defence against infection.

Next, the skin is numbed with local anaesthetic, so what you should feel is pressure rather than sharp pain. Many clinicians now use a bedside ultrasound probe to see the vein directly on a screen and guide the needle into it. A second video on this site, "Central Venous Catheter Placement with Ultrasound Guidance", is devoted to exactly that technique and describes how ultrasound is used to guide placement.

Once the needle is in the vein, a thin guidewire passes through it, the needle comes out, and the catheter is threaded over the wire into position. The wire is removed, each channel of the line is checked and flushed, and the catheter is secured to the skin with stitches or a securing device and covered with a sterile dressing. A chest X-ray or other confirmation is commonly used to check the tip position before the line is put to work.

What the line is actually used for

Once it's in, a central line becomes a workhorse. It can deliver fluids, blood products, nutrition, and medicines — including medicines that would irritate or damage smaller veins. It can be used to take blood samples, which spares you repeated sticks. Some lines have more than one channel, so different infusions can run at the same time through separate pathways. Certain catheters are placed for dialysis, where blood needs to move to and from a dialysis machine, and some are used to monitor pressures in the circulation as part of critical care.

If the idea of a tube near the heart sounds alarming, it may help to compare it with a more familiar device: our guide to urinary catheters walks through another everyday hospital catheter in the same plain terms, and our overview of endotracheal intubation covers another common critical-care procedure you may see in the same unit.

Living with a line, and taking it out

While the line is in, the care is mostly about protection. The dressing is kept clean, dry, and intact, and it's changed on a schedule using sterile technique. Anyone using the line scrubs the access hubs before connecting anything, and the team checks the site daily and asks, every day, whether the line is still needed — because the safest central line is the one that comes out as soon as its job is done.

The risks the team is guarding against are mainly infection entering along the line, a blood clot forming in or around the catheter, and the line moving out of position. That's why new redness, swelling, pain at the site, leaking, or a fever is always worth reporting straight away rather than waiting for the next round.

Removal, when the day comes, is usually brief and done at the bedside. You'll typically lie flat, the securing stitches or device are released, and the catheter is drawn out smoothly — often while you breathe out or hold a breath — followed by firm pressure and a dressing over the site. Most people find taking it out far easier than having it put in.

So the short version is this: a central line is simply a more durable, more capable kind of IV, placed with a careful sterile routine into a large vein near the heart. If you're offered one, ask which type it is, what it will be used for, and how long it's expected to stay — those three answers explain almost everything about the days that follow.

References & further reading

• MedlinePlus — Central venous catheters - ports: https://medlineplus.gov/ency/patientinstructions/000491.htm
• MedlinePlus — Central line infections - hospitals: https://medlineplus.gov/ency/patientinstructions/000474.htm
• National Cancer Institute — Central Venous Catheter (Dictionary of Cancer Terms): https://www.cancer.gov/publications/dictionaries/cancer-terms/def/central-venous-catheter
• Nemours KidsHealth — Central Lines (Central Venous Catheters): https://kidshealth.org/en/parents/central-lines.html

Frequently Asked Questions

Does having a central line placed hurt?

The skin is numbed with local anaesthetic first, so most people feel pressure and pushing rather than sharp pain during placement. The site can ache a little afterwards. If pain at the site gets worse instead of better, tell your care team — increasing pain is one of the things they want to hear about.

How long can a central line stay in?

It depends on the type of line and why you need it. Some lines are placed for short-term hospital care and removed within days, while tunnelled lines and ports are designed for treatment lasting weeks or months. Your team reviews the need for the line regularly and removes it when it's no longer required.

Can I shower with a central line?

Usually only with precautions, and the rules differ by line type. The dressing must stay dry and intact, so your nursing team will show you how the site is protected during washing — and swimming or soaking the site is generally off the table while a temporary line is in. Follow the specific instructions you were given for your line.

What's the difference between a central line and a PICC?

Both end in a large central vein near the heart. A central line is inserted directly through the neck, chest, or groin, while a PICC is inserted into a vein in the upper arm and threaded from there to the central position. The choice depends on how long access is needed, what will run through it, and your individual situation.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about central venous catheters, not medical advice and not a diagnosis. Whether this treatment, or any treatment, is right for you is a matter for your own care team, who know your results and your history.