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Deb Gnegy
Tunneled line vs. implanted port for TPN

This evening, I interjected on a surgeon asking another physician if an implanted port would be ok for daily parenteral nutrition.

I provided that an implanted port was not the best choice of a life-long daily infusion.  And that at tunneled line would be a better choice.

Is this correct? I'm questioning my advice after referencing my new INS manual P. 482 and P. 427. 

I didn't get any pt details such as age, activity, or med conditions.


Always the patient's choice

I firmly believe and constantly teach that the patient must be involved in this decision. It is the patient that must manage the line therefore it should not be the physician or any other provider who unilaterally makes this decision. I can see where both catheters can and should be an option for long term PN. It is usually cyclic given at night. Think of the person who wishes to be totally free of anything external during the business day and this person has no issue with sticking themselves every night to insert a new port access needle. Chest ports can usually tolerate ~2000 punctures and that is 5.47 years of nightly punctures. Then think of the person who would never wish to even try to learn how to access an implanted port themselves and would only consider a tunneled catheters. So daily activiities, lifestyle and what the patient can and can not learn to do have an impact on this decision. But it should always remain in the hands of the patient - literally and figuratively!! 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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