"How do you take care of a Hickman catheter?"

"Hickman catheter care has three core tasks: keep the exit site clean and covered with a sterile dressing (daily during the first 2–4 weeks until the cuff heals, then per policy, typically weekly), flush each lumen to keep it from clotting, and protect the catheter from being pulled or cut. Because a Hickman is open-ended, each lumen is locked with heparin (100 units/mL) after use, and the clamp is kept closed when the line is not in use. Always scrub the hub before connecting and watch the exit site for redness, swelling, drainage, or pain."

"What are the complications of a Hickman catheter?"

"The main Hickman catheter complications are central line-associated bloodstream infection (CLABSI), exit-site and tunnel infection, catheter occlusion (clot or fibrin sheath), catheter-related thrombosis of the vein, accidental dislodgement, cuff extrusion, and catheter breakage. Exit-site infection is often treatable with the catheter in place; tunnel infection and confirmed CLABSI usually require catheter removal."

"What is the difference between a Hickman and a Broviac catheter?"

"They are the same family of open-ended tunneled catheter and are cared for the same way (heparin lock, clamp closed at rest). The Broviac is a smaller-diameter version designed for pediatric patients or adults needing lower-flow access, available in very small sizes (down to 2.7 Fr) for neonates. The Hickman is the larger, often multi-lumen adult version."

"How long can a Hickman catheter stay in?"

"A Hickman catheter is a long-term device intended to stay in place for months to years, as long as it is functioning and free of infection. It is removed when therapy is complete or if a complication such as confirmed CLABSI, tunnel infection, irreparable occlusion, or breakage occurs."

Hickman Catheter: Information, Care and Maintenance, and Complications

Tunneled central catheters — the Hickman catheter chief among them — are the workhorse external long-term central line. This guide covers what a Hickman is, its indications, day-to-day care and maintenance, complications and how to manage them, removal, and how patients care for a Hickman catheter at home.

Parent guide: Tunneled Central Venous Catheters: Hickman, Broviac, and Groshong Clinical Guide · Central Venous Catheters: Complete Clinical Reference

What is a Hickman catheter?

A Hickman catheter is the classic open-ended tunneled central venous catheter. A soft silicone catheter is passed under the skin from a chest-wall exit site to a venous entry point (typically the internal jugular or subclavian vein), with the tip positioned at the cavoatrial junction. The subcutaneous tunnel physically separates the skin exit site from the vein, and a Dacron polyester cuff in the tunnel promotes tissue ingrowth over 2–4 weeks — anchoring the catheter and creating a biological barrier against infection.

Hickman catheters are available in single, double, and triple lumen configurations and in sizes from roughly 6.6 Fr to 14 Fr. Each external lumen has a clamp, which is kept closed at rest because the open-ended tip allows blood to reflux into the lumen.

Hickman vs. Broviac vs. Groshong

Catheter	Tip design	Lock solution	Typical use
Hickman	Open-ended (clamp required)	Heparin 100 units/mL	Adult long-term access, home TPN, transplant
Broviac	Open-ended (clamp required)	Heparin 100 units/mL	Pediatric/neonatal and smaller adult access (down to 2.7 Fr)
Groshong	Pressure-sensitive valve	Saline only	Heparin allergy/HIT; eliminates routine heparin lock

The Broviac is simply a smaller-diameter Hickman cared for in the same way; see the Broviac catheter guide for pediatric specifics.

Indications

Hickman catheters are chosen when a patient needs reliable central access for frequent (daily or near-daily) external use over months to years, and when an implanted port is not suitable:

Home total parenteral nutrition (TPN)
Long-term IV antibiotics
Chemotherapy and oncology access
Hematopoietic stem cell (bone marrow) transplantation
Frequent blood draws and transfusions

Hickman catheter care and maintenance

Three tasks define safe Hickman maintenance: exit-site care, flushing, and protecting the catheter.

Exit-site care

The exit site is the primary infection entry point and the most important maintenance activity.

First 2–4 weeks (before the cuff heals): daily sterile dressing changes.
After the site is healed and the cuff is fibrosed: per institutional policy, typically weekly.
Technique: clean with a CHG-based antiseptic, inspect the exit site for erythema, swelling, tenderness, and drainage, palpate along the subcutaneous tunnel for tenderness or warmth, apply a new sterile dressing, and secure the catheter so there is no tension on the exit site.

Flushing and locking

Flush each lumen with normal saline before and after every use (SASH where medications are given).
Lock with heparin 100 units/mL when the lumen is not in use — required because the open-ended tip allows blood reflux.
Keep the clamp closed whenever the lumen is not connected.
Scrub the hub with alcohol or CHG for 15 seconds and allow it to dry before every access.

Protecting the catheter

Secure external lumens to prevent snagging, keep the dressing intact and dry, and keep a clamp nearby in case of catheter damage.

Hickman catheter complications

Complication	Recognition	Management
CLABSI	Fever/rigors with use, positive cultures	Blood cultures (peripheral + catheter), antibiotics; removal for confirmed CLABSI
Exit-site infection	Localized redness, tenderness, purulent drainage at exit site	Topical/systemic antibiotics; catheter salvage often possible
Tunnel infection	Erythema/warmth/tenderness along the tunnel tract	Catheter removal generally required
Occlusion	Inability to flush or withdraw	Assess cause; alteplase (Cathflo) for thrombotic occlusion per protocol
Catheter-related thrombosis	Arm/neck/facial swelling, collateral veins	Anticoagulation; imaging to confirm
Cuff extrusion / dislodgement	Cuff visible at exit site, increased external length	Evaluate position; often requires replacement
Catheter breakage	Leak, fluid at hub, inability to infuse	Clamp proximal to the break immediately; repair kit or replacement

For the full complication workups (alteplase dosing, DVT management, CLABSI bundle), see Catheter Complications: Recognition, Prevention, and Management and the CLABSI Prevention Framework.

How to take care of a Hickman catheter at home

Patients and caregivers managing a Hickman at home should:

Keep the dressing clean, dry, and intact. Cover it for showering as instructed; never let the exit site get wet under an unsealed dressing.
Flush exactly as taught — saline, then heparin lock — and keep the clamp closed between uses.
Scrub the hub before connecting anything.
Watch for warning signs: fever or chills, redness/swelling/drainage at the exit site, pain or swelling in the arm, neck, or face, or a line that won’t flush.
Protect the line from pulling and keep a clamp on hand in case of damage.

The complete patient walkthrough — bathing, activity, and when to call — is in Going Home with a Tunneled Catheter (Hickman, Broviac, Groshong).

Removal

A Hickman is removed when therapy is complete or a complication requires it. Because the Dacron cuff is fibrosed into the tunnel, removal is a minor procedure: the cuff is freed (by traction or, if needed, a small cut-down) and the catheter withdrawn with the exit site dressed and monitored for bleeding.