I know there is no magical rate that will keep every VAD open. But do manufacturers make recommendation as to the least possible rate. I was told recently that a rep said 5 ml/hr was adequate so people in my area want to go with the recommendation of 10 ml/hr. I just don't think that will be enough to keep catheters open. But since I have nothing documented to back me up I'm just blowing smoke.
So now your facility is taking clinical practice recommendations from a sales representative whose job it is to sell you a specific product? This is not a valid source for clinical information. Go directly to the clinical staff of that manufacturer for any real clinical information. There is no general answer to your question. Some work has been done by manufacturers of some ambulatory infusion pumps used in home care. Typically this is lab or bench type studies and not clinical studies on real patients. It is not a specific rate of infusion put the pumping mechanism that contributes more to catheter patency, along with many factors that produce blood reflux into the lumen,patient factors, etc, etc. As you said, there is no magic rate. 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
Preaching to the choir Lynn. :) I just need documentation. I have a friend in home infusion. I'll ask her about those studies. Thanks for giving me a direction to go.
Debbie Graham BSN, RN, CRNI, VA-BC
"It takes many people to make a team, but only one to break it" --A. R. R. Tripp
So what is the rate that the nation in general is using and how did they come up with that rate?
Darla Tarvin RN VA-BC
Mercy Clermont Hospital
From a home infusion standpoint we have always used 0.2mls/hr via ambulatory infusion pump between doses and have not had a problem. That is enough flow to keep catheters from occluding in most patients. Rarely have we had to increase rate but we have never gone above 5 mls/hr.
With those ambulatory pumps, I don't think it is the actual flow rate that keeps the line patent as much as it is the pumping pressure of the pump. 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