What Is a Groshong Catheter?

Groshong central line indwelling catheters are extensively used in gynecologic oncology patients for administration of chemotherapy, intravenous fluids, and pain medications. They are easy to maintain and have a good safety record. We report on the placement of these central venous catheters under direct fluoroscopic visualization as a method which is safe, inexpensive, and efficacious in high-risk patients. Fluoroscopic visualization during insertion provides several advantages: visualization of bony landmarks, placement of the guidewire into the subclavian vein and superior vena cava under direct visualization, and confirmation of appropriate distal placement of the Groshong catheter. Patient advantages include the following: (1) avoidance of unnecessary punctures to access the subclavian vein; (2) verification of guidewire placement to avoid cephalic placement; (3) passage of the guidewire only as far as the right atrium to avoid potential dysrrhythmias secondary to right ventricular irritation; and (4) a savings of approximately 60% over insertion in the general operating room. Thirty patients had placement under fluoroscopic visualization in the angiography suite of Georgetown University Hospital. The average age of the patients was 58 years (42-78). Sixteen patients had ovarian cancer, 6 had endometrial cancer, 5 had cervical cancer, and 3 had other gynecologic malignancies. Fifteen patients had catheters placed for chemotherapy, 14 for hydration, and 1 for pain control. Ten patients had had previous central venous catheters: 6 had been removed for infection, 2 for thrombus, 1 for completion of chemotherapy, and 1 for catheter kinkage. All 10 with previous catheters had successful placement of catheters in the angiography suite. Complications from insertion were minimal with one asymptomatic pneumothorax and one proximal port in an extravascular position. We present the technique of fluoroscopic insertion of Groshong catheters which is an effective method of placement in high-risk patients.

The first SundayThe first MondayThe first TuesdayThe first WednesdayThe first ThursdayThe first FridayThe first SaturdayThe first dayThe first weekday Report format:
SummarySummary (text)AbstractAbstract (text)PubMed

Send at most:
1 item5 items10 items20 items50 items100 items200 items

What is Groshong used for?

Groshong central line indwelling catheters are extensively used in gynecologic oncology patients for administration of chemotherapy, intravenous fluids, and pain medications. They are easy to maintain and have a good safety record.

Is a Groshong a PICC?

The Groshong® PICC, Proven performance coupled with proven effectiveness. For years Groshong® PICCs have set the standard in closed-system, vascular access delivery.

What is the difference between Groshong and Hickman?

Groshong® catheters are a type of central venous catheter, which are placed under direct fluoroscopic visualization in an angiography suite. They can be tunnelled or non-tunnelled and are similar to a Hickman catheter, with the main difference being that Groshong catheters have a three-way valve at its tip.

How long can a Groshong catheter stay in?

The median duration of use was 191 days. There were no cases of pneumothorax or catheter occlusion.

Groshongs may be left in place for extended periods and are used when long-term intravenous therapy is needed, such as for chemotherapy. Similar to the Hickman line, the tip of the catheter is in the superior vena cava, and the catheter is tunneled under the skin to an incision on the chest wall, where the distal end of the catheter exits the body.

The Groshong catheter is a trademark of Bard Access Systems.

Groshong catheters are a type of central venous catheter, which are placed under direct fluoroscopic visualization in an angiography suite. They can be tunnelled or non-tunnelled and are similar to a Hickman catheter, with the main difference being that Groshong catheters have a three-way valve at its tip.

The catheter is usually tunneled under the skin through an incision on the chest wall where it exits the body. History and etymology These catheters wereinvented by LeRoy E. Groshong , MD, a US-based surgical oncologist.

An evaluation of Groshong central venous catheters on a gynecologic oncology service.

A Groshong catheter is a small hollow tube that is inserted into a large vein just below the collarbone. This type of catheter may used for long-term intravenous therapy and infusions. This intravenous catheter can also be used for blood draws.

The catheter is then threaded down several inches until the tip of it rests just above the heart in a vein called the superior vena cava. The opposite end of the catheter is tunneled approximately three to four centimeters (1.18 to 1.57 inches) below the surface of the skin.

Occasionally, an individual may experience an irregular heartbeat because the tip of the catheter is very close to the heart. Once the Groshong catheter is no longer needed, it can be removed easily by qualified health care personnel.

Abstract

Groshong central line indwelling catheters are extensively used in gynecologic oncology patients for administration of chemotherapy, intravenous fluids, and pain medications. They are easy to maintain and have a good safety record. We report on the placement of these central venous catheters under direct fluoroscopic visualization as a method which is safe, inexpensive, and efficacious in high-risk patients. Fluoroscopic visualization during insertion provides several advantages: visualization of bony landmarks, placement of the guidewire into the subclavian vein and superior vena cava under direct visualization, and confirmation of appropriate distal placement of the Groshong catheter. Patient advantages include the following: (1) avoidance of unnecessary punctures to access the subclavian vein; (2) verification of guidewire placement to avoid cephalic placement; (3) passage of the guidewire only as far as the right atrium to avoid potential dysrrhythmias secondary to right ventricular irritation; and (4) a savings of approximately 60% over insertion in the general operating room. Thirty patients had placement under fluoroscopic visualization in the angiography suite of Georgetown University Hospital. The average age of the patients was 58 years (42-78). Sixteen patients had ovarian cancer, 6 had endometrial cancer, 5 had cervical cancer, and 3 had other gynecologic malignancies. Fifteen patients had catheters placed for chemotherapy, 14 for hydration, and 1 for pain control. Ten patients had had previous central venous catheters: 6 had been removed for infection, 2 for thrombus, 1 for completion of chemotherapy, and 1 for catheter kinkage. All 10 with previous catheters had successful placement of catheters in the angiography suite. Complications from insertion were minimal with one asymptomatic pneumothorax and one proximal port in an extravascular position. We present the technique of fluoroscopic insertion of Groshong catheters which is an effective method of placement in high-risk patients.

Application[edit]

Groshongs may be left in place for extended periods and are used when long-term intravenous therapy is needed, such as for chemotherapy. Similar to the Hickman line, the tip of the catheter is in the superior vena cava, and the catheter is tunneled under the skin to an incision on the chest wall, where the distal end of the catheter exits the body.In contrast to the Hickman line, the tip of a Groshong line has a three-way valve, which is formed by a slit in the sidewall of the catheter tip. The valve opens outward during infusion, and opens inward during blood aspiration. When not being accessed, the valve remains closed.

Procedure

Groshong® catheters are indicated when long-term IV therapy is needed such as in the following conditions:

Complications

A Groshong® catheter placement carries the risk of infection, bleeding, catheter rupture and thrombus formation.

What is a Groshong® Catheter?

A Groshong® catheter is a small hollow tube that is inserted into a large vein just below the collarbone. This type of catheter may used for long-term intravenous therapy and infusions. This intravenous catheter can also be used for blood draws.The Groshong® catheter is usually inserted in the operating room. The blunt end is inserted into a large vein that is located just below the collarbone. The catheter is then threaded down several inches until the tip of it rests just above the heart in a vein called the superior vena cava. The opposite end of the catheter is tunneled approximately three to four centimeters (1.18 to 1.57 inches) below the surface of the skin. A small incision is made to allow the catheter to exit out the front of the chest.After the catheter is placed, the doctor may put a few stitches at the exit site to help hold it in place. These stitches can be removed in two to three weeks. The catheter has a unique cuff on the part of the tube that is tunneled under the skin. This cuff contains a special mix of collagen that promotes tissue ingrowth. This means human tissue will actually grow to the cuff to help hold the catheter in place.An individual may need a Groshong® catheter for various reasons. The purpose of these intravenous catheters is to provide venous access in individuals who no longer have good venous access on the arms. Groshong® catheters can stay in place for months and sometimes even years. Individuals who must get chemotherapy, frequent blood transfusions, or frequent blood draws may benefit from this type of catheter.There are risks associated with a Groshong® catheter. Infection at the exit site and bleeding can occur in some cases. Occasionally, an individual may experience an irregular heartbeat because the tip of the catheter is very close to the heart. If this happens, the doctor can re-adjust the tip of the catheter.Another risk associated with this intravenous catheter is an air embolism. This happens when a large amount of air gets injected into the catheter. Air injected into a vein can cause an individual to develop chest pain and shortness of breath. This is a medical emergency and requires immediate treatment.Once the Groshong® catheter is no longer needed, it can be removed easily by qualified health care personnel. The catheter is removed by pulling gently on the protruding tube. The catheter should break away from the tissue that has held it in place. If the catheter does not break away from the tissue, surgical removal may be necessary.