DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They
are intended to serve as a general statement regarding appropriate patient care practices based upon the available medical
literature and clinical expertise at the time of development. They should not be considered to be accepted protocol or policy, nor are
intended to replace clinical judgment or dictate care of individual patients.
CENTRAL VENOUS CATHETER SELECTION GUIDELINES
FOR SURGICAL PATIENTS
Selection of an appropriate central venous catheter (CVC) should be based upon the patient’s severity of
illness and the anticipated use of the catheter. When the current CVC does not meet the patient’s needs
or provide adequate access to the central circulation, the catheter should be exchanged over a guide wire
for an appropriate catheter.
• A dual-lumen large bore CVC should be in place in all patients who require operative procedures
UNLESS each of the following criteria are met:
¾ the scheduled procedure is considered to be minor
¾ blood transfusion or volume resuscitation will not be necessary
¾ a triple lumen CVC or two (2) large bore peripheral IV’s are in place
• A 9 French introducer should be inserted in patients who require a pulmonary artery catheter for
• Triple lumen CVC’s are appropriate in those patients who no longer require large volume
resuscitation or blood product transfusion.
• CVC’s should be removed as soon as possible based upon the patient’s stability and need for
continued vascular access (Level III).
An algorithm for the appropriate selection and utilization of CVC’s in the surgical patient population is
presented. For details on appropriate insertion techniques and maintenance of such catheters, refer to
the Intravascular Catheter Guidelines.
There is insufficient data to support either Level I or Level II recommendations regarding the selection of