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Safe techniques for inserting the hickman catheter in pediatric patients
Kouji Masumoto1, Tohru Uesugi, Kouji Nagata
1Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kmasu@pedsurg.med.kyushu-u.ac.jp
Pediatric Hematology and Oncology
|August 25, 2006
Summary
A modified technique using vascular dilators and a left-side approach improves Hickman catheter placement in children. This method reduces procedure time, complications like sheath kinking, and serum C-reactive protein (CRP) levels compared to the standard approach.
Area of Science:
- Pediatric Surgery
- Vascular Access
- Medical Device Technology
Background:
- Hickman catheter insertion via percutaneous central venous access is common in pediatric patients.
- Standard insertion methods can lead to complications such as sheath introducer kinking and damage.
- Modified techniques are being explored to enhance safety and efficiency.
Purpose of the Study:
- To compare the efficacy and safety of a modified percutaneous Hickman catheter insertion technique using vascular dilators against the standard method in children.
- To evaluate the impact of the modified technique on procedure duration, complication rates, and serum C-reactive protein (CRP) levels.
- To determine the optimal side (right vs. left) for catheter insertion.
Main Methods:
- A retrospective study of 41 pediatric patients undergoing Hickman catheter insertion.
- Comparison between a standard insertion kit method (16 patients) and a modified method using vascular dilators (25 patients).
- Analysis of procedure time, complication rates (sheath kinking/damage), and peak serum CRP levels, comparing both methods and right vs. left approaches.
Main Results:
- The modified technique significantly reduced procedure time compared to the standard method.
- The modified technique showed a lower incidence of sheath introducer kinking and damage.
- The modified group exhibited significantly lower peak serum CRP levels.
- The left-side approach was associated with shorter procedure times and lower CRP levels in both methods.
- Technical complications were more frequent with the right-side approach in the standard group.
Conclusions:
- The modified percutaneous technique utilizing vascular dilators offers a safer and smoother Hickman catheter insertion in pediatric patients.
- The left-side approach appears advantageous for reducing procedure time and inflammatory response (serum CRP).
- This modified method is recommended for improving outcomes in pediatric central venous access procedures.
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