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A Hickman line is a central venous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. Some types are used mainly for the purpose of apheresis or Kidney dialysis. They have also been used in total parenteral nutrition (TPN). Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required.
Long-term venous catheters became available in 1968, and the design was improved by Dr. John W. Broviac (b. 1942), a nephrologist based in East Lansing, Michigan, in 1973. Robert O. Hickman, after whom the system is named, further modified the principles in 1979 with subcutaneous tunneling and a Dacron cuff that formed an infection barrier. Dr. Robert O. Hickman (1927-2019) was a pediatrics nephrology at the Seattle Children's Hospital.
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 normal saline, in order to prevent the line becoming blocked by blood clots. Preventing contamination at the exit site and ensuring that the lumen is 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 area, indicate the patient should seek medical attention as soon as possible.
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