Yes, you may infuse up to D12.5W in a neonatal PIV, although our standard amino acid solution is D10 (sometimes D7.5 is ordered). I think the real question may be about osmolarity...
Indeed the issue is osmolarity and 12% dextrose is extremely hypertonic. The INS standards of practice limit the osmolarity of fluids through a peripheral vein to less than 600 mOsm per liter. This document was reviewed by numerous pediatric and neonatal experts, so this applies to your age group. Lynn
A PICC would be indicated for a neonate receiving TPN due to the hyperosmolarity of TPN. This is well supported by the INS along with the NANN Guidelines. The risk of extravasation is high with infusing TPN peripherally. In our NICU, pts receiving TPN would be an automatic referral for a PICC.
Darcy Doellman RN BSN CRNI
Vascular Access Nurse
Cincinnati Children's Hospital Medical Center
[quote=Tanya Nauman]
We have a question from an NICU nurse who questions the NICU practice of infusing
D12 with amino acids through PIV's. Is this done in other hospitals...and is it acceptable
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
A PICC would be indicated for a neonate receiving TPN due to the hyperosmolarity of TPN. This is well supported by the INS along with the NANN Guidelines. The risk of extravasation is high with infusing TPN peripherally. In our NICU, pts receiving TPN would be an automatic referral for a PICC.
Darcy Doellman RN BSN CRNI
Vascular Access Nurse
Cincinnati Children's Hospital Medical Center
[quote=Tanya Nauman]
We have a question from an NICU nurse who questions the NICU practice of infusing
D12 with amino acids through PIV's. Is this done in other hospitals...and is it acceptable
practice? Thanks.
Tanya
SHMC
Eugene, OR
[/quote]Darcy Doellman