Hello
What is the proper procedure for using multilumen CVAD for drawing blood when Parenteral Nutrition is running? Our policy stated to wait for 10 minutes for TPN and 1 min for any other infusion. The 10 min wait time seem to long to me - especially if frequent blood work is required.
Thank you
Diana
I agree! 10 mins without any infusion or locking is far too long and does not provide any additional benefit. This could easily lead to lumen occlusion from backflow of blood into the lumen. I have been looking at the literature on blood drawing from all VADs and I have not found a study that addresses this specific question. There are studies of drawing blood samples for therapeutic drug monitoring from a CVAD but most have used the stop time of 2 minutes. This particular aspect has not been studies and I have not seen any studies looking at PN and blood draws. Think about the rapid and large blood flow in the SVC. This should be sufficient to move any infusate downstream and far away from the lumen exits so that the sample would not be contaminated by the infusing fluid. Lynn
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
Thank you for the feedback. Just an FYI, I came across this published article that recommended 10 min wait time:
Fairholm, L., et al. (2011, Dec 28). Monitoring parenteral nutrition in hospitalized patients: Issues related to spurious bloodwork.
Nutrition in Clinical Practice. from http: //ncp.sagepub.com/content/26/6/700.full.pdf
I guess for infrequent bloodwork, the 10 min wait times is okay; but I just worry re-the impact for patients who require multiple bloodworks -- Diana
Thanks, I missed that one. Lynn
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