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Robbin George
TPN and Groshong

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."

daylily
We have a limited number of
We have a limited number of people that can draw blood from central lines.  We also have a good share of Groshong Piccs and do not have a problem with hemolyzation.  Actually, for us the ability to draw blood is better with this catheter than our open-ended catheters in which we have eliminated heplocking (but that is a separate subject).
bartina
Nancy Rose RN IV Team VA

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 

lynncrni
First, Groshong is not a

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, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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