Hickman line

A Hickman line in a leukemia patient. It is tunnelled under the skin to the jugular vein.

WikiDoc Resources for Hickman line

Articles

Most recent articles on Hickman line

Most cited articles on Hickman line

Review articles on Hickman line

Articles on Hickman line in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Hickman line

Images of Hickman line

Photos of Hickman line

Podcasts & MP3s on Hickman line

Videos on Hickman line

Evidence Based Medicine

Cochrane Collaboration on Hickman line

Bandolier on Hickman line

TRIP on Hickman line

Clinical Trials

Ongoing Trials on Hickman line at Clinical Trials.gov

Trial results on Hickman line

Clinical Trials on Hickman line at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Hickman line

NICE Guidance on Hickman line

NHS PRODIGY Guidance

FDA on Hickman line

CDC on Hickman line

Books

Books on Hickman line

News

Hickman line in the news

Be alerted to news on Hickman line

News trends on Hickman line

Commentary

Blogs on Hickman line

Definitions

Definitions of Hickman line

Patient Resources / Community

Patient resources on Hickman line

Discussion groups on Hickman line

Patient Handouts on Hickman line

Directions to Hospitals Treating Hickman line

Risk calculators and risk factors for Hickman line

Healthcare Provider Resources

Symptoms of Hickman line

Causes & Risk Factors for Hickman line

Diagnostic studies for Hickman line

Treatment of Hickman line

Continuing Medical Education (CME)

CME Programs on Hickman line

International

Hickman line en Espanol

Hickman line en Francais

Business

Hickman line in the Marketplace

Patents on Hickman line

Experimental / Informatics

List of terms related to Hickman line

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

A Hickman line is an intravenous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. Some types of Hickman lines are used mainly for the purpose of apheresis or dialysis. Hickman lines may remain in place for extended periods and are used when long-term intravenous access is needed.

The insertion of a Hickman line is usually done under sedation or a general anesthetic by a radiologist or surgeon. It involves two incisions, one at the jugular vein or another nearby vein or groove, and one on the chest wall. At the former incision site (known as the "entrance" site), a tunnel is created from there through to the latter incision site (known as the "exit" site), and the catheter is pushed through this tunnel until it "exits" the latter incision site. The exit site is where the lumens are seen as coming out of the chest wall. The catheter at the entrance site area is then inserted back through the exit site and advanced into the superior vena cava, preferably near the junction of it and the right atrium of the heart. The entrance site is sutured. The catheter at the exit site is secured by means of a "cuff" just under the skin at the exit site, and the lumens are held down otherwise by a sterile gauze or dressing centered on the exit site, which also serves the purpose of preventing potential contamination at the exit site. Throughout the procedure, ultrasound and X-rays are used to ascertain the positioning of the catheter.

Long-term venous catheters became available in 1968, and the design was improved by Broviac et al in 1973. Hickman et al, after whom the system is named, further modified the principles with subcutaneous tunneling and a Dacron cuff that formed an infection barrier. Dr Robert O. Hickman was a pediatric nephrologist at the Seattle Children's Hospital and Regional Medical Center.

Potential complications of placement of such a line include hemorrhage and pneumothorax during insertion and thrombosis or infection at later stages. Patients with a Hickman line therefore require regular flushes of the catheter with heparin, in order to prevent the line becoming blocked by blood clots. Preventing contamination at the exit site and ensuring that the lumens are flushed frequently is especially important for oncology patients, as they may have become immunocompromised as a result of cytotoxic chemotherapy. Pyrexia (fever) is one of the symptoms of contamination. This symptom, and others, including the observance of swelling or bleeding at the exit site, indicate that the patient should seek medical attention as soon as possible.

## See also[edit | edit source]

* Groshong line
* PICC line
* Central venous catheter

## External links[edit | edit source]

* Video from the Royal College of Surgeons of Edinburgh showing the insertion of a Hickman line
* Operative details of the Hickman line removal
* Guidelines for the flushing of Hickman lines in adult patients in the community setting

## References[edit | edit source]

* Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973;136:602-6. PMID 4632149.
* Hickman RO, Buckner CD, Clift RA, Sanders JE, Stewart P, Thomas ED. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979;148:871-5. PMID 109934.
* Bard Access Systems, Hickman, Leonard and Broviac Central Venous Catheters instruction manual.

Template:WH Template:WS