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Trimming piccs

Does anyone have any information on any consequences of trimming piccs above the graduated openings?   If a patient has a triple lumen and is getting incompatiple meds through each lumen and all lumens exit the picc at the same point, what happens if placed correctly in the SVC?  We are considering going to all 55cm and trimming to save space and I want to be sure we won't be opening ourselves up to problems as a result.

Thank You

Diane Suter, RN


 This has been discussed

 This has been discussed extensively on this forum and you can find those posts by searching in the box in the upper right corner. Trimming has been shown to produced jagged edges and extra small pieces hanging off the catheter, but has not been correlated to specific clinical outcomes. 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


the following study you can obtain from JVIR discusses the safety of trimming and incompatibles


Cumulative Experience with 1,273 Peripherally Inserted Central Catheters at a Single Institution’ 

JVII1 1996; 7:5-43

The only study that I know of

The only study that I know of looking specifically at infusion of incompatibles is Collins and Lutz, Heart and Lung 1991;20:271-7 In vitro study of simultaneous infusion of incompatible meds in multilumen catheters.  It is from National Institutes of Health and is an eye opener.  This article compares trimmed multilumen catheters (adjacent exit ports) with those exit ports that are staggered.  To address your specific question about the blood flow in the the very tip of a catheter that has been trimmed, the medications all exit the catheter at the same time, thus mixing.  Yes, there is 2000 ml/minute of blood in the SVC, but when the meds exit the tips, they mix at the very tip.   Collins demonstrates this very nicely. 

I am also aware of two additional article that address catheter with staggered exit ports in peripheral veins...Jamovich and Champolini, late 1980's or 1990 or so.   





Cheryl Kelley RN BSN, VA-BC

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