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Alma Kooistra
Stem Cell Harvest

During a particularly difficult placement of the 2 large-bore peripheral IVs for stem cell harvest, one of our nurses placed an aquapheresis catheter (ELC, from chf solutions) for both harvest and return of blood.

It certainly worked well in this case but as with the aquapheresis procedure it may not always be the answer.

Wondering whether others are utilizing this catheter for this procedure and what sorts of outcomes.....

Alma Kooistra CRNI

 Where does the catheter tip

 Where does the catheter tip end up? If it is placed in the midclavicular area which would be the axillo-subclavian vein for the actual tip location, I would never use it for infusion of any fluids or medications. This tip location has been shown to produce a rate of thrombosis about 4 times greater than the SVC. So I would remove the catheter after the procedure is complete or ensure that the tip is either midline or SVC. 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

Alma Kooistra
The tip is near the axilla. 

The tip is near the axilla.  Catheter is 15 cm long and placed low near the AC space so it doesn't get beyond that spot.  It's a dual lumen designed for rapid blood removal and return......which is what the stem cell harvest requires as well.  Other than blood return it is not used for infusion and is removed post procedure.  It actually makes pretty good sense to me to use this catheter but it is not designed for this purpose.  I've emailed the manufacturer to pose the question but they have not responded.  I may give them a call.

The show-stopper is cost.  The fee for insertion of an ELC catheter is the same as for PICC insertion (currently $1055), and we place the large bore peripherals without additional billing to the patient.  If there were an insurance review we might get a ding on that.

Alma Kooistra CRNI

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