Clinical Study of Hickman Catheters in Pediatric Oncologic Patients

Lee, Young Ho

Abstract

PURPOSE: We performed a retrospective study to evaluate the complications from Hickman catheters in pediatric oncologic patients.
METHODS
Between October 1992 and July 1995, 27 Hickman catheters placed in 25 patients who were chemotherapy candidates were evaluated. The frequency and etiologic organisms of catheter infections, mechanical complications, and any problems that might have been related to catheter use were determined.
RESULTS
1) The average duration of catheter life was 99.2 days, yielding a total accumulated experience of 2,479 catheter days. There were 31 occasions (1.22/100 catheter day) of catheter sepsis, and 5 occasions (0.20/100 catheter days) of superficial infections including 1 tunnel infection and 4 exit site infections. 2) Catheter sepsis were caused by 18 gram negative rods (58%), 8 gram positive cocci (26%), 2 gram positive bacilli (6%), and 3 fungi(10%). 3) There were 35 occasions (1.41/100 catheter days) of occlusion, of which 34 occasions successfully treated with urokinase. 3 occasions of dislodgement, 3 occasions of leakage, and 1 occasion of hypersensitivity reaction to heparin were also noted.
CONCLUSIONS
The Hickman catheter is a useful and reliable method of maintaining central venous access in pediatric oncologic patients, but further studies are required to offer a practical approach to the management of Hickman catheters and their complications.