Forum topic

Hello,
I have a 12mo old patient with short gut and is on TPN 12hrs a day. He is on his 3rd broviac due to various fractures. His mom reports that initially his broviac catheters work great, but it is not long after they get sluggish to flush, but always has a good blood return. Mom has used tPA in the past with no big change in ease of flushing. She is also doing ethanol x3 days/week. In the past with the use of ethanol instilled for a long time his broviac has occluded, so mom started doing shorter dwell times with an occasional longer dwell time. Mom says that the catheter flushes a little easier with the longer dwell times, but does not last. She also does bigger saline flushes (at least 5mls) after disconnecting the TPN/Lipids using the push-pause method and before hep locking. Any suggestions/ideas to help in dealing with the sluggish flushing.