Catheters: Types, Uses, and Considerations

Catheters are essential medical devices used for various clinical purposes, primarily to drain fluids from or introduce fluids into the body. 

They play a critical role in the management of numerous health conditions, from urinary retention to vascular access for medication or dialysis. 

The use of catheters is widespread in healthcare, and understanding the different types and their specific applications is vital for healthcare professionals. 

Below is a detailed breakdown of the main types of catheters, their uses, and the key considerations for their management.

Image: foley catheter

Types of Catheter and Their Purpose

1. Urinary Catheters
2. Vascular Catheters
3. Dialysis Catheters
4. Cardiovascular Catheters
5. Neurological Catheters
6. Gastrointestinal Catheters
7. Pulmonary Catheters
8. Reproductive Catheters

Key Considerations for Catheter Use

Types of Catheter and Their Purpose

1. Urinary Catheters

Urinary catheters are used to drain urine from the bladder in patients who cannot urinate naturally. 

They are commonly used in patients who are undergoing surgery, have urinary retention, or need continuous bladder drainage.

• a) Indwelling (Foley) Catheters: These are inserted into the bladder through the urethra and remain in place for an extended period. A balloon at the end of the catheter is inflated to keep it in position. Indwelling catheters are commonly used post-surgery or for patients who require long-term bladder drainage.
• b) Intermittent Catheters: These are inserted into the bladder only when needed to drain urine and are then removed. They are often used for patients who can manage self-catheterisation or those who only need temporary bladder drainage.
• c) External (Condom) Catheters: These catheters are designed for male patients and fit over the penis like a condom. They are connected to a drainage bag and are commonly used for patients who experience incontinence but do not require an internal catheter.

Purpose: Urinary catheters manage urine drainage in various medical conditions and are vital for patients with urinary retention or incontinence.

2. Vascular Catheters

Vascular catheters provide direct access to the bloodstream for medication delivery, fluid administration, or blood sampling.

• a) Central Venous Catheters (CVC): These catheters are inserted into large veins, usually in the neck, chest, or groin, and are used for long-term access to the bloodstream. CVCs are often used for chemotherapy, intravenous medications, and parenteral nutrition.
• b) Peripherally Inserted Central Catheters (PICC): PICC lines are inserted into a peripheral vein in the arm and advanced to a central vein. These are used for long-term treatments like antibiotics or chemotherapy and are often preferred for patients who need central access but with fewer complications.
• c) Peripheral Intravenous Catheters (IV): These are short-term catheters placed in the peripheral veins, typically in the hand or arm, for quick access to administer medications, fluids, or blood products.

Purpose: Vascular catheters provide reliable venous access, making them essential for critically ill patients or those requiring long-term treatments like chemotherapy or total parenteral nutrition (TPN).

3. Dialysis Catheters

Dialysis catheters provide access to the bloodstream for patients who require hemodialysis, a process that filters waste from the blood when the kidneys are no longer functioning properly.

• a) Tunneled Dialysis Catheters: These catheters are placed under the skin and have a longer path to the vein. They are designed for long-term dialysis access and are more secure, reducing the risk of infection.
• b) Non-Tunneled Dialysis Catheters: These are short-term catheters inserted directly into a central vein, often used for emergency dialysis or when immediate access is required.

Purpose: Dialysis catheters enable access to the bloodstream for hemodialysis, supporting patients with end-stage renal disease or acute kidney failure.

4. Cardiovascular Catheters

Cardiovascular catheters are used in the diagnosis and treatment of heart conditions, particularly during procedures such as angiography or balloon angioplasty.

• a) Angiography Catheters: These catheters are used to inject contrast dye into the blood vessels to view blockages or abnormalities during imaging procedures like an angiogram.
• b) Balloon Catheters: Used in angioplasty procedures, these catheters have a balloon that inflates to open up blocked or narrowed blood vessels in the heart or other parts of the body.
• c) Guiding Catheters: These are used to guide other devices, such as stents or wires, into the blood vessels during cardiovascular procedures.

Purpose: Cardiovascular catheters facilitate minimally invasive heart procedures, helping diagnose and treat cardiovascular diseases like coronary artery disease.

5. Neurological Catheters

Neurological catheters are used to drain cerebrospinal fluid or monitor intracranial pressure in patients with neurological conditions.

• a) Ventricular Catheters: These are inserted into the brain’s ventricles to drain cerebrospinal fluid (CSF) in patients with hydrocephalus or traumatic brain injury.
• b) Lumbar Drainage Catheters: Inserted in the lower back, these catheters drain CSF and are often used to manage conditions like spinal cord injury or to reduce pressure around the brain.

Purpose: Neurological catheters help manage fluid build-up in the brain or spine, often preventing life-threatening complications.

6. Gastrointestinal Catheters

Gastrointestinal catheters are used to manage feeding, drainage, or medication delivery directly into the stomach or intestines.

• a) Nasogastric Tubes: These tubes are inserted through the nose and down into the stomach. They are used to deliver food, fluids, or medications, or to drain stomach contents.
• b) Gastrostomy Tubes: Surgically inserted into the stomach, these tubes are used for long-term feeding in patients who cannot swallow or require nutritional support over extended periods.

Purpose: Gastrointestinal catheters support patients who need help with feeding or medication delivery when oral intake is not possible.

7. Pulmonary Catheters

Pulmonary catheters are used to drain fluids or help manage respiratory function in patients with lung conditions.

• a) Thoracic Catheters (Chest Tubes): These tubes are inserted into the pleural cavity to drain air, blood, or fluid from around the lungs in cases of pneumothorax or pleural effusion.
• b) Tracheostomy Tubes: Inserted into the windpipe, these tubes help patients breathe when the airway is blocked or damaged, often used in long-term respiratory support.

Purpose: Pulmonary catheters assist in respiratory management, ensuring the lungs remain functional by draining excess fluid or providing an airway for patients with respiratory issues.

8. Reproductive Catheters

Reproductive catheters are used in fertility treatments and reproductive procedures.

• a) Intrauterine Insemination (IUI) Catheters: These are used to deliver sperm directly into the uterus during fertility treatments.
• b) Embryo Transfer Catheters: These are used to transfer fertilised embryos into the uterus during in vitro fertilisation (IVF) procedures.

Purpose: Reproductive catheters play a crucial role in fertility treatments, improving the chances of conception through precise delivery of sperm or embryos.

Key Considerations for Catheter Use

Each type of catheter requires specific insertion techniques, maintenance, and removal protocols to avoid complications. It’s important to note that catheter use can pose risks such as:

• Infection: Catheters create an entry point for bacteria, making infections a common risk. Proper sterilisation and care are critical.
• Tissue Damage: Improper catheter insertion or long-term use can cause trauma to the tissues or organs, leading to discomfort or complications.
• Thrombosis: In vascular catheters, blood clots can form, leading to blocked vessels and increased risk of complications.

Training and Skill: Proper catheter training for healthcare professionals is essential to ensure correct insertion, maintenance, and removal of catheters. This not only reduces the risk of complications but also improves patient outcomes and comfort.

Catheters are indispensable in modern healthcare, and knowing the different types and their uses is essential for providing safe and effective care. By understanding the appropriate application and risks associated with each type, healthcare providers can ensure the best possible outcomes for their patients.