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ipadonai
Increased risk of DVT's with certain PICC manufactures?

My facility is evaluating new PICC manufactures for Power and Non-power PICC's. Certain manufactures have stiffer lines, possibly contributing to the development DVT's. I would like to get some feedback from the group regarding key points for evaluation of new PICC manufactures: what to look for and what to avoid.

We need:

- triple-lumen power and non-power for our ICU patients

- CVP monitoring

- nitinol wire

- full nursing safety kit

I appreciate the responces.

Inna Perfido, RN, BSN

Vascuar Access, Charleston, SC

lynncrni
The issue of thrombogenicity
The issue of thrombogenicity of catheter material has been studied extensively. There is no difference between the amount of thrombosis associated with either silicone or polyurethane. Polyurethane is a stiffer material but it softens after insertion when it reaches body temperature. The benefit of polyurethane is that it is a stronger material allowing for a larger inner diameter. Larger catheters are reported to cause more risk of thrombosis, but there has not been any studies published to my knowledge of the thrombosis risk associated with power-injectable PICCs. Many are using these now and anecdotally report that they do not see a greater amount of thrombosis. But the majority of catheter-related thrombosis is clinically silent. 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

ipadonai
Lynn, How about Durathane

Lynn,

How about Durathane Power PICC's by AngioDynamics? It is a stiffer material in comparison to the Polyurethene catheters by other manufactures.

Inna

lynncrni
There are 3 categories of
There are 3 categories of polyurethane and all brands fall into one of these three. There is virtually no difference between the rates of thrombosis. So I am not quite sure what you are asking about this particular brand. All polyurethanes will become softer when they reach body temperature because all polyurethanes are thermoplastics, meaning they respond to temperature. No brand has been shown to be better or worse than another brand. 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

estevens102206
There differences in the

There differences in the actual size of these polyurethane PICCs though. The Bard power PICCs taper over two French sizes from tip to hub. So the Bard 5 French double lumen power PICC actually is over 7 French near the hub. I believe AngioDynamics make both a non-tapered and a tapered power injectable PICC. Arrow make a power injectable PICC that does not taper. So while the polyurethane material may be the same, be sure and look closely at the actual diameter of the PICC line you choose.  

Eric

Eric

lynncrni
There is also a difference
There is also a difference in the length of this taper. The shorter ones of around 3 cm would not have must of this larger portion inside the vein, while the longer tapers would. But again, there is only anecdotal and not published peer-reviewed studies about these issues of thrombosis generation. 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

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems 

Venous thrombosis associated with placement of a PICC - JVIR 2000 - Allen

Nurses's low tech, cepahilic high thrombosis rate of 57%, Basilic 14%, Brachial 10%

3F, 4F, 5F DL catheters and size did not matter with thrombosis

Each patient averaged 3 PICC lines

higher rate with multiple PICC lines

 

 

Kathy Kokotis

Bard Access Systems

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