The intravenous administration of drugs is often required for medications that cannot be absorbed and utilized effectively when taken orally. However, some medications may need to be given over and over again to be effective, which can make simply using an IV needle difficult, as repeated insertion of an IV can cause pain, bruising, collapsed veins, and infection. For these types of situations, such as in patients receiving chemotherapy, a longer-term solution is indicated.
A Broviac catheter is actually very similar to another medical device called a Hickman line. A Hickman line is a catheter that can be inserted in one of the central veins, thus providing long term intravenous access. These types of catheters are used to allow repeated administration of IV drugs without needing to re-puncture the vein each time.
Broviac vs. Hickman
The main difference between a Broviac catheter and a Hickman line is the size of the lumen. Broviac catheters have a much smaller lumen, which means that the actual tube which is inserted into the vein is smaller. This makes Broviac catheters ideal for children, because they have smaller veins and a larger lumen is unnecessary and could cause pain.
Uses for Broviac Catheters
Broviac catheters and other venous lines are typically used for the administration of chemotherapy. Chemotherapy often requires repeated and long-term administration of an intravenous drug. These catheters also make it easy to withdraw blood for analysis, which is also critical for monitoring the effectiveness of treatment of childhood cancers.
Broviac Catheter Installation
Broviac catheters are usually installed on a patient while he or she is sedated. The surgeon will make an incision near the jugular vein. The catheter is then pushed down through the jugular vein until it reaches the superior vena cava, which feeds directly into the heart. This allows physicians to have what is called "central vein access," in which they can effectively introduce drugs directly into the center of the circulatory system.
During installation of a Broviac catheter, it is important to make sure that uncontrolled hemorrhaging does not occur in the child. Once the catheter is in place, the major concerns are blood clots and infection. Because an infection could quickly become life threatening (because the catheter runs very close to the heart), it is important to keep the site of insertion clean and sterilized at all times.
Adam Cloe has been published in various scientific journals, including the "Journal of Biochemistry." He is currently a pathology resident at the University of Chicago. Cloe holds a Bachelor of Arts in biochemistry from Boston University, a M.D. from the University of Chicago and a Ph.D. in pathology from the University of Chicago.