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Random VAT person
Bard triple lumen HF cath

Hi, The Bard triple lumen HF cath has 1  18g that is power injectable and two 19g that are not.  I noticed the withdraw of blood to check for patency is considerablely slower in the two 19g lumens. 


Does anyone have problems with blood or TPN/lipids infusing in the smaller lumens.  I think they are sluggish due to the 5 fr size and lower gravity rate.


Triple 5 Fr 2 18 Ga. / 19 Ga. / 19 Ga. 743 ml/hr / 280 ml/hr / 280 ml/hr 0.68 ml / 0.44 ml / 0.44 ml
 You are probably dealing

 You are probably dealing with a lot of different problems. This couls easily be fibrin sheath/thrombus areound the catheter tip, lipid sludge buildup intraluminally, intraluminal thrombotic occlusion.Where is the tip location of these CVADs? If not at the CAJ, this increases risk of thrombosis. I do not follow your numbers. Are you saying those are the reported flow rates for the lumens? If so, these flow rates are done with an isotonic fluid infusing by gravity at 3 meters or 39 inches. TPN and lipids has a must higher osmolarity and viscosity and therefore a much slower rate than what is reported. Finally, are you aspirating slowly with a 10 mL syringe? Try changing to a smaller syringe for aspriation as this will exert less intraluminal pressure. What is the shape of these lumens - round, D, oval, elipitical? That could also have an impact. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Sluggish Bard Triple Lumen

We are using Bard's newer 5 fr triple lumen catheter, not the HF though.  Yes we do find the smaller lumens are a little sluggish than we were used to as compared to the 6 fr.  If you really need a rapid infusion I tell the nurses to use the largest lumen.  That is the one for power injections, the other two are not.  It has taken a little getting used to the new feel but we feel it has been worth it as we have seen a decrease in symptomatic UE-DVT due to the smaller french size.  We had begun restricting who we would put a 6 fr triple lumen in due to the issues.  The 5 fr triple lumen has been successful enough that we no longer carry the 6 fr.  If I recall correctly the Bard rep explained to me that the HF was tapered a little more where it makes the curve through the upper chest possibly adding to what you feel.  Of course there is always the possiblity of development of fibrin etc that Lynn discussed.  But if you are discussing a newly placed PICC our team and the nurses noticed the difference right away.  Since the guage of the lumens is smaller we encouage thorough flushing to make sure nothing is building up since it is a smaller catheter overall, especially if it is being used for lab draws for some of our patients.

Mary Penn RN Vascular Access Team

St Charles, MO

Random VAT person
Thanks for the input.  I am

Thanks for the input.  I am not having issues but I did notice right away that the 19g lumens had a little more resistance even with a freshly placed line.  I had a patient that was receiving TPN/Lipids, Vanc, Mag, and Potassium.     I had the nurse use the 18g lumen for TPN/Lipids, and use another lumen for Vanc, then the third lumen for Mag/ Potassium.  It seemed to work fine.  Any EBP to the contrary?

We have been using them for

We have been using them for several years and have not had any issues.

5 Fr. Triples

I agree with Mary's statement, we have been using the 5Fr. triple lumen HF Bard power PICC catheter for just over a year now.  Some of the nurses noticed right away when we switched the sluggishness in flushing the smaller lumens.  We informed them of the change in lumen size and to use the larger port for the more viscous solutions.  We hear very little from the nurses on this subject now that they have gotten use to them. 

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