Identifying complications of central venous catheters: infection, thrombosis, occlusion

(1) The signs of infection of implanted port catheters are inflammation along the course of a central catheter, oozing or signs of an abscess of the pocket in which the port is implanted. Catheter-related venous thrombosis should be suspected in the event of pain, oedema, local swelling, a palpable venous cord and development of superficial collateral circulation; (2) The rapid appearance of local signs and symptoms at the time of injection suggests extravasation of the injected drug; (3) Catheter patency should be checked with normal saline, never using too much force if resistance is encountered. If there is a thrombotic occlusion, the catheter can often be unblocked with heparin, or if not, with urokinase. There is only a moderate risk of bleeding if these agents are used carefully.