The central venous catheter (CVC) is very important in patients that require TPN. For patients with short bowel syndrome and others, the well known complications of CVC are a challenge for pediatric surgeons. To keep the CVC functioning is demanding and a lot of guidelines and recommendations must be followed. It is common to use CVC for blood sample aspiration. Do you think that in certain difficult patients, one should be conservative in taking blood samples?
I personally think that blood sampling from a central line does increase the rate of CVC complications, such as malfunctioning and infection, and therefore the "life" of the line. Moreover, especially when on TPN, tests on blood withdrawn from the same line may be considerably altered, especially if the line is not properly flushed before taking the sample. In conclusion, I would definitely opt for a peripheral vein to obtain blood sampling.
Yes definitly one should be careful because every time the CVC Line is touched the probability off becoming contaminated is increasing. There is quite a lot of literature about that
There is a genuine theoretical risk of damaging the endothelium in vicinity of the opening where the tip of the line ends in which suction is applied. This would predispose to thrombosis and line failure. Better to avoid it unless there is no other option.
I think the central catheter should be maintained inviolate as possible; blood samples should be made by peripheral vein and sampling from the CVC only in exceptional cases. It 'important to ensure the most rigorous asepsis. The CVC related infection and thrombosis shorten the life of the line. You can read the references and my papers about CVC's.
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