I have been working at my  hospital for over 5 years and we have always infused TPN and Lipids through our ports. We now have a surgeon that puts in ports asking us to place a picc line on patients with ports for the purpose of infusing the TPN. His satatement was that they cause infection in the ports. Had a discussion with an Oncologist and an ID Doc. Onc. Dr. was on the fence post as in his previous hospital did not use ports for TPN and the ID Dr. states that ususally the infected ports he sees have underlying causes other that just TPN. Like numerous ABX killing all the flora and seeing yeast. ID doc didn't think risk was any higher with port vs picc. So here ther more information out there about ports and TPN that I am missing. Any input would be helpful. Thanks in advance.
Nancy Sullivan Rn
Implanted ports have the lowest overall infection rates among all patients and therapies. So you are not missing anything. The problem with ports and TPN is the question of do you leave it accessed continuously or does the patient stick themselves nightly to start their cyclic TPN and dc the needle in the morning. I am not supportive of having a port remain accessed continuously due to the fact that there can easily be needle disldogement that leads to extravasation injury. So infection is not the biggest risk here.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Robbin George RN VA-BC