Table 3.

Types of intravascular devices and comments on their use.

Type of intravascular device	Comment
Peripheral venous catheter	Usually inserted into the veins of the forearm or the hand; the most commonly used short-term intravascular device
Peripheral arterial catheter	For short-term use; commonly used to monitor hemodynamic status and to determine blood gas levels of critically ill patients; risk of bloodstream infection may approach that of CVCs
Midline catheter	Peripheral catheter (size, 7.620.3 cm) is inserted via the antecubital fossa into the proximal basilic or cephalic veins, but it does not enter central veins; it is associated with lower rates of infection, compared with CVCs
Short-term CVC	Most commonly used CVC; accounts for the majority of all catheter-related bloodstream infections
Pulmonary artery catheter	Inserted through a teflon introducer and typically remains in place for an average duration of only 3 days
Pressure-monitoring system	Used in conjunction with arterial catheter; associated with both epidemic and endemic nosocomial bloodstream infections
Peripherally inserted central catheter	Provides an alternative to subclavian or jugular vein catheterization; is inserted via the peripheral vein into the superior vena cava, usually by way of cephalic and basilar veins; similar risk of infection as CVCs in patients hospitalized in intensive care units
Long-term CVC	Surgically implanted CVC (e.g., Hickman, Broviac, or Groshong catheter) with the tunneled portion exiting the skin and a dacron cuff just inside the exit site; used to provide vascular access to patients who require prolonged chemotherapy, home-infusion therapy, or hemodialysis (figure 2)
Totally implantable device	A subcutaneous port or reservoir with self-sealing septum is tunneled beneath the skin and is accessed by a needle through in-tact skin; associated with low rates of infection

NOTE. CVC, central venous catheter