Five years' experience with Hickman catheters as temporary access for haemodialysis

Two different types of Hickman catheters were used as central venous access for haemodialysis. The device was implanted in 58 patients with chronic renal failure, already undergoing haemodialysis, because of thrombosis or infection of the previous vascular access, in order to permit immediate treatment and in nine patients with acute renal failure, as a 'first choice' method suitable either for dialysis or for parenteral infusions and nutrition. The catheter was inserted, under local anaesthesia, through the external jugular vein up to the right atrium; the haemodialysis treatment was carried out by single-needle technique 3-4 times weekly and all the catheters were filled daily with heparinised saline and Miconazole solution. The mean duration was 76 +/- 93 days with an overall of 2253 treatments. The flow rate ranged between 150 and 290 ml/min, with acceptable recirculation rate and biochemistry similar to that of standard dialysis. The complication rate was 20%, including thromboses and infections; no operative mortality nor major complications were observed. Based on these data, we believe that the Hickman catheter represents the ideal method of temporary access for haemodialysis.