Central venous access is essential in providing quality medical care to many patients for whom intensive therapy is required. In many situations, a semipermanent tunneled central line is preferred (see Indications). An anterior approach to the internal jugular vein (IJV) is the best option in this situation because it offers the easiest route with a low risk of complications.
In this procedure, a tunneled catheter is surgically inserted into a vein in the neck or chest and passed under the skin. Only the end of the catheter is brought through the skin; medicines and intravenous (IV) fluid can be administered through this catheter; other tasks, such as blood sampling, can also be performed. The fact that the catheter is passed under the skin helps secure the catheter, reduces the rate of infection, and permits free movement of the catheter port. The placement of a tunneled catheter should be carried out by practitioners with specific experience in the procedure.