Therapies

Hickman catheter

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Of the Hickman catheter is a special, partially implanted catheter that, unlike the normal central venous catheter, can remain in the vein for extended periods of time. Read all about the Hickman catheter, how it works and what its risks are.

ArtikelübersichtHickman catheter

  • What is a Hickman catheter?
  • When to put a Hickman catheter?
  • How do you put a Hickman catheter?
  • What are the risks of a Hickman catheter?
  • What should I watch out for with a Hickman catheter?

What is a Hickman catheter?

A Hickman catheter is a thin, usually multi-barreled (internally split) plastic tube, which is pushed over a larger vein to the superior vena cava just before the right atrium of the heart. The connection is like the normal central venous catheter (CVC) on the skin. However, the Hickman catheter runs between the infusion port and its entry into the vein within the subcutaneous tissue, which is why it also belongs to the so-called partially implanted, underneath tunneled catheters. Inside the "tunnel" sits an additional sleeve of antibiotic impregnated material. These and the longer course of the subcutaneous tunnel protect the catheter from infection. The Hickman catheter has up to three access tubes to the main tube.

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When to put a Hickman catheter?

A Hickman catheter is used when patients need central venous access for a long time. Especially with chemotherapy or stem cell transplantation and larger amounts of infusion (artificial nutrition) Hickman catheter are preferred to other access routes.

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How do you put a Hickman catheter?

Before inserting a Hickman catheter, your doctor will tell you about the benefits and risks in a personal interview, check your blood counts and write an ECG. Under local anesthetic, the skin is now opened with a small incision next to the sternum below the third or fourth rib. Through this, the catheter with a long needle under the skin is usually advanced to the large arm vein below the lateral clavicle (vena cephalica) or to the inner jugular vein on the lower neck (jugular vein interna).

Now the appropriate vein is punctured from the outside as in a normal CVC system and a guidewire pushed to just before the right atrium. The catheter tube can now be advanced on this "threaded" to its final position in front of the right heart.

The catheter is now fixed with a small suture and covered with sterile plasters. A final X-ray image ensures the correct position and also serves to rule out accidental injuries of the pleura or lungs (risk of pneumothorax).

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What are the risks of a Hickman catheter?

The risks of a Hickman catheter are diverse, but can be minimized by a professional intervention and consistent hygiene. Possible complications include:

  • infections
  • Injuries to vessels and nerves
  • Bruising (hematoma)
  • Arrhythmia
  • Pneumothorax - Air enters the gap between the lungs and the pleura
  • Air embolism - air enters and closes the vessels

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