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Kidznurs
Multiple VADs in one patient

Any info on multiple vascular access devices in the same patient? For example a patient with a picc and a port. Or a patient with a midline and a broviac. Or a patient with a broviac, picc and midline? Looking for any outcome studies, risks, benefits or personal anectdotes. Thanks!

lynncrni
I can't recall seeing any

I can't recall seeing any studies, however this is done all the time. It is based on the need for multiple incompatible infusions Broviac is a surgically inserted CVAD with a tunnel and cuff. Most atr single lumens. So when other needs arise, you have no choice but to put in another VAD of some kind if a single lumen is not sufficient. It would not be apporpirate to remove a single lumen tunneled cuffed CVAD just to insert a double lumen Broviac/Hickman. The new need is probably short term, so it is appropriate to use a VAD for that short term use and then remove it. It all depends on the numbers of infusions and what is needed to infuse incompatible solutions. The number of lumens does increase risk of CLABSI, meaning there has to be close attention to management of the hub and entire infusion system for all lumens and VADs. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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