I recently ran across an article that stated the immediate initiation of vasopressors through a freshly placed PICC line, increases the risk of DVT by 65%.
For the life of me, I can't relocate the article. Has anyone else seen the article or have statistics on the initiation of vasopressors immediately following a PICC line placement?
As I recall, the increased risk was due to the pathphysiology involved with the mechanism of injury when a vessel is punctured, i.e. release of clotting factors, venospasm, etc.
Thank you,
Amber
I noticed no one has replied to your question, so I will add a few thoughts. While I have not read all the literature on PICC and thrombosis, I have read a lot but have never seen the article you are asking about, nor has this concept been in anything I have read. The rationale you proposed does not make sense to me. If this were the case - venipuncture causing release of clotting factors - then it would happen with any type of VAD insertion and not just PICCs. We do know that PICCs have a high rate of thrombosis due to the length of vein involved and are NOT recommended for use in critical care and oncology patients for that reason. This is coming from many studies, and is in the MAGIC guidelines and INS Standards of Practice. So PICC should not be the VAD of choice when vasopressors are to be infused as that would be a critical care patient. For all PICCs, the inserter must pay close attention to making sure that the catheter consumes less than 45% of the vein lumen, so French size is very important. Hope this helps, Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn. I had accidently found the article while searching for something unrelated to PICC's and DVT's. Unfortunately I can't remember what my keyword was and will probably never find it again. I did read it aloud to another team member so at least I know I didn't dream it.
Our team is barely over a year old and we are struggling with convincing physicians of the MAGIC guidelines and not placing the lines in critically ill patients. We haven't even touched on Oncology patients.
But thank you again, this is a great forum.