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NDodge
serous drainage at PICC site

Can you think of an etiology to continued serous drainage 2 weeks post PICC insertion?  There are no signs of infection, blood cx negative, PICC functioning perfectly.  No DVT, no signs of phlebitis.  Pt is not on blood thinning medications.  However every day, the biopatch is saturated with serous fluid.  Any help trouble shooting this would be greatly appreciated.

 

lynncrni
Yes, a lympn node was injured

Yes, a lymph node was injured near the puncture site and is drainimg lymph fluid. Or the catheter is damaged with a hole leaking out fluid being infused. Can you test the glucose level in this fluid? Lymph fluid will be a high number although I have never seen a reference range. If you are infusing dextrose the glucose would also be high. 

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

NDodge
I don't think the catheter is

I don't think the catheter is damaged since he is on a continuous 24 hour home IV pump - there would be a lot more drainage if that was the case I would think.  The lymph node issue is interesting and I will see what I can do to rule that in or out.  PICC line went in easily with a very short turniquet time and this is a young healthy person.   If it is a lymph node, is there anything that could be helpful to slow the drainage?  Thank you for your expertise.

lynncrni
If a lymph node was damaged,

If a lymph node was damaged, there is no way to stop the drainge except to remove the catheter. 

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

Deedee7065
We have similar problem. The

We have similar problem. The patient still need about two weeks of infusion. Question is, do we have to remove and change the PICC or can we continue to use the PICC after all potential problem had been rule out and change the dressing daily? 

Thank you

wlemay
Serous drainage at PICC site

I have seen this in patients that have generalized edema or 3rd spacing of fluid. The fluid simply finds the path of least resistance, the exit site. I do also agree with Lynn regarding possible lymph node damage. 

Bill LeMay, RN, VA-BC

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