Use of the Hickman catheter for central venous access in patients with haematological disorders.

Hickman catheters were inserted for access in the management of 70 patients with haematological disorders. Twelve patients received a second and one patient a third catheter. The resultant 16,283 catheter-day experience is reviewed. The complication rate was 0.28 per 100 catheter days. Sepsis in the form of catheter-related septicaemia (CRS) and exit site infection was responsible for 72% of complications. Staphylococcus epidermidis was the commonest organism isolated from cases of CRS. Patients receiving broad spectrum antibiotics on the day of catheter insertion were significantly less prone to catheter failure due to CRS or exit site infection (P = 0.008). The Hickman catheter is a useful and reliable method of maintaining central venous access, but prospective randomised trials are required to evaluate the role of prophylactic antibiotics in reducing the incidence of CRS.