{"entity":{"id":"tunnelled-cuffed-central-venous-catheters","kind":"technology","name":"Tunnelled cuffed central venous catheters (Hickman-type lines)","aka":["Hickman line","Hickman catheter","Broviac catheter","Groshong catheter","Tunnelled central line","Tunneled CVC","Skin-tunnelled catheter","Cuffed central venous catheter"],"tldr":"A tunnelled line is a soft tube that runs under the skin of the chest for a few centimetres before entering a large vein in the neck or under the collarbone, with its end outside the body. A small cuff under the skin anchors it and helps keep germs out, so it can stay in for months of chemotherapy, blood tests and transfusions.","summary":"The CDC/HICPAC catheter guideline (2011, last updated 2017) lists tunnelled central venous catheters as implanted into the subclavian, internal jugular or femoral veins, at least 8 cm long depending on patient size, and notes that the \"cuff inhibits migration of organisms into catheter tract\", with a lower rate of infection than non-tunnelled central lines. Unlike an implanted port the external end stays outside the skin, so it needs regular dressing changes and flushing but no needle through the skin for each use.\n\nIn adults with cancer, the MAGIC-ONC panel (2025, RAND/UCLA appropriateness method) rated a double-lumen PICC or a tunnelled central venous catheter as appropriate for acute haematological cancers needing urgent chemotherapy, regardless of treatment intensity or infusate, and a single-lumen tunnelled catheter or implanted port as appropriate for chemotherapy in solid tumours. The infections these lines can carry are counted as central line-associated bloodstream infections, and the prevention bundles in the SHEA 2022 update apply to them.","status":"standard-of-care","asOf":"2026-11-11","links":[{"label":"CDC/HICPAC: Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011 (last update October 2017), Table 1","url":"https://www.cdc.gov/infection-control/media/pdfs/Guideline-BSI-H.pdf"},{"label":"The Michigan Appropriateness Guide for Intravenous Catheters in Adult Patients With Cancer (MAGIC-ONC), Ann Intern Med 2025 (doi 10.7326/ANNALS-25-02523)","url":"https://europepmc.org/article/MED/41183333"},{"label":"Buetti et al., Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update (Infect Control Hosp Epidemiol 2022)","url":"https://europepmc.org/article/PMC/PMC9096710"}],"tags":["supportive-care-gaps-2026-11"],"related":[],"cancers":["aml"],"sections":["chemotherapy","supportive-care","devices"],"technologies":["implanted-ports","picc-lines","infusion-devices-vascular-access","catheter-lock-solutions","needleless-connector-disinfecting-caps"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["central-venous-access"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo supportive care gap fill (CDC, NHSN, SHEA, Society for Endocrinology, ESMO, MASCC, ASCO, ASTCT, NCI PDQ, Europe PMC)","editedOn":"2026-11-11"},"principle":"A catheter passed through a tunnel under the skin before it enters a large central vein (subclavian, internal jugular or femoral), with its external end outside the skin; a cuff in the tunnel anchors it and inhibits migration of organisms along the catheter tract.","strengths":["Long-term central venous access for treatment, blood tests and transfusion","Lower infection rate than non-tunnelled central lines (CDC 2011)","Accessed without a needle through the skin"],"limitations":["External end needs dressing changes and flushing","Bloodstream infection, blood clots in the vein and blockage remain the main risks","Placement and removal are procedures"]},"route":"/technologies/tunnelled-cuffed-central-venous-catheters/","neighbours":{"cancer":[{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"catheter-lock-solutions","kind":"technology","name":"Catheter lock solutions (heparin, taurolidine and DefenCath)","route":"/technologies/catheter-lock-solutions/"},{"id":"needleless-connector-disinfecting-caps","kind":"technology","name":"Disinfecting caps for needleless connectors (Curos)","route":"/technologies/needleless-connector-disinfecting-caps/"},{"id":"ethanol-lock-therapy","kind":"technology","name":"Ethanol lock therapy for central venous catheters","route":"/technologies/ethanol-lock-therapy/"},{"id":"implanted-ports","kind":"technology","name":"Implanted ports for chemotherapy (port-a-cath, power-injectable, apheresis and intraperitoneal ports)","route":"/technologies/implanted-ports/"},{"id":"infusion-devices-vascular-access","kind":"technology","name":"Infusion pumps, ports, and ambulatory chemotherapy devices","route":"/technologies/infusion-devices-vascular-access/"},{"id":"picc-lines","kind":"technology","name":"Peripherally inserted central catheters (PICC lines)","route":"/technologies/picc-lines/"}],"term":[{"id":"central-line-associated-bloodstream-infection","kind":"term","name":"Central line-associated bloodstream infection (CLABSI)","route":"/terms/central-line-associated-bloodstream-infection/"},{"id":"central-venous-access","kind":"term","name":"Central venous access (port, PICC line)","route":"/terms/central-venous-access/"}]}}