We have a chemo patient with single lumen PICC who now requires TPN. What is the best option - insert another PICC on the other side? Or insert a percutaneous non-tunneled catheter? Our surgeon wants to remove the PICC and insert a short term percutaneous non-tunneled catheter. But the patient will still require a CVAD after the TPN is finished so will require another insertion. We do not feel this is a good option but do not know what is the best option in this case.
Any suggestions?
Thank you
Is the TPN continuous or cyclic? If cyclic given only at night, you can give the chemo during the day with no problem. If continuous, you will need some other type of VAD. What is the chemo - vesicant or not? For how long is the chemo courses or how many courses over what period of time? How frequently is the chemo given? How long do you anticipate the need for TPN? All of these questions should be answered before you can make an appropriate recommendation for the VAD needed. 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
I would not use the same lumen for both TPN and chemo. I might consider doing an overwire exchange to a dual lumen PICC. One lumen can be designated for TPN only. The other lumen can be used for chemo and lab draws.