Hello !
More and more, tunneled lines are considered in the pediatric world when we are taking care of chronic TPN babies (e.g.short gut) whose every venous accesses is their life line. To preserve their vein integrity as long as possible, we have started to tunnelize our PICC. Currently, COOK-TPN PICC seem to me be the only tunneled PICC on the market that is made of silicone (we would like it in this material for ethanol lock usage) and has a "sure cuff". Unfortunately, we ran into many breakages with those catheters and currently looking for an alternative. Any suggestions or experiences ? Has anyone tried to put a Broviac or Hickman in the peripheral access? Thanks!
Broviac is made for peds, Hickman for adults. But I think both of these is too large for insertion via peripheral veins, especially in infants and small children. I would not put too much emphasis on the "sure cuff" if that is what I think you are referring to as a silver-impreganated collagen cuff placed SC at insertion to block the tunnel. No studies have shown this to be that effective. Also, some of the new polyurethane materials may tolerate locking with ethanol. There have been some in vitro studies published about this issue. So I would not be married to silicone but would look at the other materials. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861