Question from a colleague:
"We have had trouble with a Groshong catheter in that everytime we draw blood it is hemolyzed and the K+ is then  very high. The patient is now on TPN, but even prior to TPN the K+ was high. It is consistently in the 7.0 range. IR says sometimes that just happens--Please ask if others have seen this as a problem?  Also IR specifically put in the Groshong instead of a Port as they prefer the Groshong for TPN. They say patients can get chemical phlebitis with  the Port and TPN."
Nancy Rose RN IV Team VA Medical Center Wilmington, DE (800) 461-8262 ext 4830
We have not experienced hemolysis with blood drawn from our BARD Groshong PICCs. The blood is drawn from a separate lumen and the TPN paused for at least one minute.
Nancy Rose
First, Groshong is not a type of catheter. The Groshong valve is now built onto PICCs, nontunneled CVCs, tunneled and cuffed CVCs, and implanted ports. I would also expect the person making the statement about chemical phlebitis and TPN from implanted ports to provide supportive evidence of that statement. The port needle can become dislodged with TPN flowing into the port pocket, but this would not produce chemical phlebitis. The high potassium values suggests that the technique for blood aspiration is causing cell hemolysis. Cell damage releases K as this is located inside the cells.
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