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[Value of the Hickman catheter in pediatric nephrology]
Insights
The Hickman catheter, a silicone polymer device, proved effective for pediatric hemodialysis and plasma exchange, showing no observed infections or thrombosis. This central venous catheter is a viable option for children requiring long-term vascular access.
Area of Science:
- Medical Devices
- Pediatric Nephrology
- Vascular Access
Context:
- The Hickman catheter is a silicone polymer central venous catheter.
- It is surgically inserted into the superior vena cava or right atrium.
- Pediatric patients often require long-term vascular access for treatments like hemodialysis and plasma exchange.
Purpose:
- To evaluate the efficacy and safety of the Hickman catheter in pediatric patients.
- To assess its suitability for hemodialysis and plasma exchange procedures.
- To determine the complication rates associated with its use in children.
Summary:
- The study involved 11 pediatric patients (ages 3-15 years) utilizing Hickman catheters for hemodialysis (10 patients) or plasma exchange (1 patient).
- Catheters remained in place for a mean of 48 days (up to 5 months), with satisfactory dialysis in 80% of cases.
- No instances of catheter-related infection or thrombosis were reported, and the catheter was not flushed between sessions.
Impact:
- The Hickman catheter demonstrates a favorable safety profile and efficacy for pediatric hemodialysis and plasma exchange.
- It offers a reliable solution for vascular access in children, potentially reducing complications.
- Findings suggest the Hickman catheter can be used for extended durations, supporting its role in managing pediatric chronic conditions.
Abstract:
The Hickman catheter is a single or double lumen catheter made of a silicone polymer; it is introduced surgically into the superior vena cava or the right atrium. The authors have used this catheter in 11 children, aged from 3 to 15 years and weighing from 10 to 40 kg, either for haemodialysis in children without arteriovenous fistula (n = 10), or for plasma exchanges (n = 1). In 5 of the 10 children, an arteriovenous fistula was created while the catheter was being installed. The catheter was left in place for a mean period of 48 days and a maximum period of 5 months. Data from the literature suggests that this instrument can be used for even longer periods. Dialysis was satisfactory in 8 out of 10 cases. No infection or thrombosis of the catheter was observed. The catheter was not perfused between haemodialysis sessions or blood exchanges.