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Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model

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Groshong catheters: technical aspects and clinical features.

C Campisi¹, L Camillucci, A Campopiano

¹National Research Council - Institute of Biomedical Technologies, Rome - Italy.

The Journal of Vascular Access

|July 20, 2007

Summary

Blood withdrawal issues with Groshong catheters are complex. Our study found no single cause, suggesting multifactorial origins and offering practical solutions for clinicians.

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Area of Science:

Medical Devices
Vascular Access
Catheter Technology

Background:

Groshong catheters, despite extensive use, present unexplained blood withdrawal difficulties.
These drawbacks are observed in both open- and closed-tip designs, with the Groshong valve implicated.
Understanding the root causes is crucial for improving clinical practice.

Purpose of the Study:

To investigate the relationship between potential causes and blood withdrawal drawbacks in Groshong catheters.
To identify practical solutions for clinicians to mitigate these complications.
To evaluate the role of the catheter valve and material properties.

Main Methods:

Examination of 16 Groshong catheters after varying implantation times (up to 36 months).
Ultrastructural analysis using electron microscopy.
Measurement of valve closing pressure.
Assessment for intraluminal clots and fibrin sleeves.

Main Results:

No clear correlation found between ultrastructural findings, closing pressure, intraluminal clots, and clinical failures.
Internal and external catheter surfaces showed optimal, time-independent aspects.
Valve closing pressures (22-36 cmH2O) were within functional limits.

Conclusions:

Blood withdrawal drawbacks are multifactorial, not attributable to a single cause like silicone biostability or the valve itself.
Slime/clots (internal) and fibrin sleeves (external) are likely contributors, common in open-tip catheters.
Suggested solutions include optimal catheter tip placement in the atrium and post-implant flushing/postural maneuvers.