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vessel occlusion

We have been collecting data regarding DVT rates and vessel occlusion in our facility for several months now.  Our target range of occlusion has always been 30-50%.  Obviously, all of our patients have fallen into this range so we have looked at other factors for DVT causes....When we are placing single lumen catheters, we have typically placed a 4F since the occlusion percentage is less.  I'm wondering if this is causing more harm than it possible that because we are occluding such a small percentage of the vessel (typically <20%) that we may be in fact causing more damage to the vessel wall than if we were placing a larger catheter just because there would be more friction from blood flow?  Curious as to your thoughts and reccomendations...... 

I guess I am not following

I guess I am not following your rationale, but all studies that have assessed catheter diameter have found that smaller sizes produce less thrombosis. Of course there are numerous other factors that increase the risk of thrombosis including tip location other than the CAJ, insertion technique (faster produces more vein trauma), catheter stabilization that can lead to excessive movement, secondary malposition of the tip during dwell. Then add many patient factors such as hypercoaguablility (cancer, diabetes, etc). I firmly believe that smaller catheters leaving more intraluminal vein space for blood flow is far better than a larger catheter consuming more of the intravenous space. 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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