Bibliographic information
GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
WHO suggests using either a Hickman central venous catheter (CVC) or a Port-a-Cath in adults, adolescents, children and neonates requiring a long-term line. (Long-term catheters only) (All population)
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
- PICCs were not included in the comparison as they were considered in previous guidelines (11).
- The decision on which type of long-term line to be inserted should be based on clinical needs and patient preferences. Please see also under implementation considerations below.
- The recommendation applies to adults, adolescents and children, but not neonates as Hickman CVC and Port-a-Cath are not applicable for this age group. The decision on which long-term central line to be inserted should be based on the clinical need and patient preferences. The choice between a Hickman line versus a Port-a-Cath depends on factors such as the type and duration of treatment, the patient’s lifestyle, maintenance requirement, and the risk of infection, as summarized below.
- Hickman line When it is used: often chosen for patients who need continuous or frequent IV access over a long period, such as for chemotherapy, total parenteral nutrition or long-term antibiotics. Advantages: it has external lumens that allow for easy access without the need for repeated venipunctures. It can also accommodate multiple infusions simultaneously if it has multiple lumens. Generally easier to insert and requires fewer specialized resources than a Port-a-Cath.
- Port-a-Cath (or totally implantable venous access devices) When it is used: typically recommended for patients who require long-term, intermittent treatments such as chemotherapy, long-term antibiotics, or regular infusions. It is also used when frequent blood sampling is needed. Advantages: the device is implanted entirely under the skin, making it less prone to infection and more discreet and convenient for patients (allowing greater mobility). It can remain in place for months or even years.