Increased infection rate in double-lumen versus single-lumen Hickman catheters in cancer patients

Over the 48-month period from January 1983 through December 1986, 51 single-lumen (SL) and 94 double-lumen (DL) indwelling central venous (Hickman) catheters were placed in 118 patients with malignant disease. We reviewed these cases retrospectively to determine the types and frequency of complications requiring catheter removal. The catheters were in place a total of 18,397 days. Overall, 14% (7/51) of SL and 21% (20/94) of DL catheters were removed due to infection. Of those catheters becoming infected, DL catheters were infected earlier. SL catheters that became infected averaged 213 days of use before removal, whereas DL catheters becoming infected averaged only 78 days before removal (P less than or equal to .02). The infection rate was significantly less in SL (one infection per 1,210 days) than in DL catheters (one infection per 496 days) (P less than or equal to .02). Thus because of its significantly reduced risk of infection, the single-lumen Hickman may be the preferred catheter for long-term venous access in many patients.