If TPN is infusing, can CT contrast be administered through the other lumen of a power PICC, or should we pause the TPN briefly to do the contrast inject?
there are numerous types of IV contrast agents. You would need to confirm compatiblity with all PN solutions with the specific contrast agent being used. Solutions could contact each other at tip and form a precipitate. Both are hypertonic solutions. You would also need to confirm that the CVAD is rated for power injection by checking for the instructions for that specific type/brand. All CVADs are not power injectable.
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
I’m confused; I thought it was ok to infuse incompatibile fluids through a central line. Isn’t this one of the reasons we have the central line?
Read the original question again. It was specifically about parenteral nutrition, which has numerous components and additives. As I mentioned there can be precipitate formed at the tip. There has only been a single lab study on the outcome of staggered tip exit sites, but they demonstrated that PN with another highly incompatible med did produce precipitate at tip. As with all combinations, you must assess the most recent compatiblity data. Do not rely on the old chart on the wall because this data changes frequently.