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TPN infusions via infusaports

Recently, we have had a few orders to place PICC's in patients that already have an infusaport. The PICC would be used for infusing TPN.  When questioned on the rationale for second central line we were told that the patient would be at an increased risk for infection if TPN infused thru their port, and or that they didn't want to ruin their port (these comments are coming from MD's and NP's).  I have never heard of any data indicating the above findings.  Actually, I would think that they would be at higher risk for developing an infection since they'd now have 2 central catheters in place.  I have tried to google this topic, but have not been successful in finding any research to back up their concerns.



I wrote one reply and forgot

I wrote one reply and forgot to hit Save on the new system. So let me try again. First I would hold those MD & NPs responsible for providing the evidence to support their ideas. I don't think they can do that but I would make it clear to them that I was expecting that from them. I don't know what they mean by "ruin an implanted port" with PN solution. Are they referring to infection risk or lipid sludge?

There would be serious concerns when the patient has only a single lumen port. PN should have a dedicated lumen. But please note that this is not the same as the so-called "virgin" line for PN. When piggybacking into PN, the issues are infection and solution compatibility. So you will need to look at the other types of therapies required and see if multiple lumens are needed. This would be a justification for a PICC or some other type of CVC. 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

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