What Is a Tunneled Central Line?

A tunneled central line is a special type of catheter used to deliver medications, fluids, or nutrition directly into a large vein near the heart. This catheter is placed under the skin and guided into a central vein, making it a secure and long-lasting option for patients who need frequent or long-term treatments like chemotherapy, antibiotics, or dialysis. Unlike a standard IV, a tunneled line stays in place for weeks or months and reduces the need for repeated needle sticks.

Because it is placed under the skin, a tunneled central line is less likely to become infected compared to external lines. It also offers a more comfortable experience for patients needing extended care. This type of catheter is carefully positioned by a trained healthcare provider, often with imaging to ensure accurate placement. It provides stable, reliable access for therapies that require frequent or continuous infusion into the bloodstream.

Key Takeaways

A tunneled central line is a long-term IV catheter placed under the skin, often used for chemo or dialysis treatments.
Unlike regular IVs, this catheter travels under the skin before entering a vein, helping reduce the risk of infection.
Doctors use image guidance like ultrasound or X-ray during placement, making the procedure safer and more precise for the patient.
Tunneled lines need regular care, like flushing and dressing changes, to keep them clean and working properly over time.
This type of central line can stay in place for weeks or months, giving patients consistent access for needed medical treatments.

Understanding Tunneled Central Lines

What Is a Tunneled Central Line?

A tunneled central line is a thin, flexible tube placed into a large vein—typically in the neck, chest, or groin—that leads to a central vein near the heart. What makes it different from other central lines is that it is “tunneled” under the skin for a few inches before entering the vein. This tunnel acts as a barrier to bacteria and helps lower the risk of infection.

These lines are used for long-term access to the bloodstream, especially when treatment requires consistent, repeated, or long-lasting infusions. Conditions that may call for a tunneled line include cancer, kidney failure, chronic infections, and severe nutritional deficiencies. Doctors may also use it when other IV access is difficult or no longer possible.

The line is placed during a short surgical procedure, often done with local anesthesia and imaging guidance like ultrasound or fluoroscopy. After placement, part of the catheter remains visible outside the body, allowing for easy connection to IV tubing and medications.

Why Is It Called "Tunneled"?

The term “tunneled” refers to the technique used to insert the catheter. A healthcare provider creates a small path or tunnel under the skin before inserting the catheter into the vein. This tunnel helps secure the line and acts as a protective barrier against infection. Additionally, a small cuff on the catheter sits inside the tunnel and encourages tissue to grow around it, holding the line in place and providing extra protection.

This tunneling also allows the catheter to exit the skin at a site away from the vein’s entry point. That makes it easier to care for and more comfortable for the patient. The skin tunnel and the cuff together help prevent bacteria from reaching the bloodstream, which is especially important during long-term treatment.

How Tunneled Central Lines Work and When They're Used

Common Uses in IV Therapy

Tunneled central lines are essential for patients who need long-term intravenous therapy. Common reasons for placement include chemotherapy for cancer, long-term antibiotic use, total parenteral nutrition (TPN), and frequent blood draws. They’re also often used for hemodialysis in patients with kidney disease, particularly when arteriovenous (AV) fistulas are not an option.

One major advantage of a tunneled line is that it offers stable and consistent access to the bloodstream without repeated needle sticks. This makes treatment more comfortable and safer, especially for patients who have fragile veins or require multiple medications.

Types of Tunneled Central Lines

There are several types of tunneled central lines, and the right one depends on the treatment plan. Two common types are Hickman and Broviac catheters. Hickman lines are often used for chemotherapy or blood draws and have multiple lumens (or channels) for different medications. Broviac lines are similar but typically used in pediatric patients due to their smaller size. Another type is the Groshong catheter, which has a special valve to help prevent blood from backing up into the line.

Each of these catheters is designed to stay in place for weeks or months and requires regular cleaning and care to reduce the risk of infection or clotting. The care routine includes flushing the line with saline or heparin, changing the dressing, and checking for any signs of infection.

Benefits and Considerations

Tunneled lines are designed for safety and long-term use. Since they’re placed under the skin, they’re more secure than regular peripheral IVs and can be used even during everyday activities like showering, with proper protection. The risk of infection is lower than with non-tunneled central lines because of the skin tunnel and cuff that help block bacteria.

However, these lines still carry some risks. Possible complications include infection, blood clots, line displacement, and catheter blockage. Patients and caregivers are trained to spot early warning signs and to perform regular catheter care. It’s also important to follow all healthcare provider instructions and attend regular follow-up appointments to ensure the line continues to work safely.

Tunneled central lines are a vital part of treatment for many chronic and long-term conditions. They allow for high-quality care while improving patient comfort and reducing the need for repeated needle sticks.