Comparison of the flow rates of central venous catheters designed for rapid transfusion in infants and small children.

Large-bore Hickman catheters are useful in infants and small children for the rapid transfusion of blood or fluids into the central circulation. Recently high-flow plastic sheaths have been developed for the same purpose. We compared the flow rates of normal saline, 5% albumin and packed red blood cells through two sizes of Hickman catheters that have been recommended for major surgery in infants to five sizes of Arrow plastic sheaths of comparable external diameters, and to 14 and 16 gauge Jelco catheters. The flow rates of all three solutions through the plastic sheaths and the 14 gauge Jelco catheters were superior to both sizes of Hickman catheters. Shortening the Hickman catheters improved their flow. High-flow plastic sheaths can provide a useful alternative to Hickman catheters in patients where permanent, large-bore central venous catheters are not required. Hickman catheters should be shortened as much as safely possible if massive haemorrhage is anticipated.