Our PICC team was just informed that we will be placing these catheters prior to patients starting aquapheresis treatment for CHF. Any information regarding complications associated with these catheters would be greatly appreciated. Beth R
Our PICC team was just informed that we will be placing these catheters prior to patients starting aquapheresis treatment for CHF. Any information regarding complications associated with these catheters would be greatly appreciated. Beth R
We placed these for awhile, but not so much lately. The ELC catheter is essentially a large bore 2-lumen midline (15 cm?) catheter. They are used for aquapheresis only and we label these with a note 'not to be used for infusion'. There is a stainless steel coil in the product we use, so we also put a note on the medical record indicating this patient is not to have an MRI while this catheter is in place.
We avoid the temptation to place high above the antecubital space because the tip must not exit the limb. If you put it up high the tip may go past the shoulder and this does not allow monitoring of complications at the tip. Another reason to keep them low is because this is a fairly stiff catheter and you will get your best flow if the catheter is straight and the tip centrally located in the vessel. If the catheter needs to curve to get to final destination the tip may end up against the vessel wall and you cannot get rapid blood return.
We got our best information on how to use these catheters by perusing the package insert.
A Kooistra CRNI
Interesting....We also place the ELC dual lumen catheter and we were placing as instructed by the rep. below the axilla(midline). We were having tons of problems(spasms)with our withdraw line.A nurse that works for the company then came in and told us to place the tip beyond the axilla as we would get better withdraw. I have questioned that because of the fact that it is supposed to be just a midline catheter but that is what she told us to do.
Karen Ratz,RN, VA-BC Unity Point St. Lukes Hospital, Cedar Rapids,IA
We have been placing lines for aquapheresis for a couple of years now and have not had any difficulty during removal. These lines do not always provide adequate blood flow for filtering. I have found that placing a 7 french dual lumen catheter (IJ or axillary/subclavian insertion) has had better results. Additionally, many of our CHF patients are also CKD 3+ patients and we should avoid a line in their upper extremity and benefit from IJ insertion.
Regards
Judy