I am carrying out a research on catheter lock solution and i need the help of specialist.
-Do you know in each oncology unit the split (in %) of patients treated with cannulae, PICCS, Hickmans and ports? (do not hesitate to give an opinion even you are not sure)
-Do you know which lock solution is mainly used for PICCS, Hickmans and ports?
-Do you know if groshong PICCS are more used than open ended PICC or if in the long term if they will replace open ended PICCS?
THanks for you help
Jul 11, '12
Are you thinking that LTC patients are safer with Valved IV catheters versus non-valved? I'm assuming that is your premise. Also, here in the USA, Heparin Lock solution (10u/ml, 100U/ml, etc), is the only "locking" solution we currently have approved to prevent fibrin build-up/occlusions. In many cases, cost is the determining factor as to which catheter is used. Groshongs are one of the most expensive, albeit appropriate for many residents as it is easily repaired and easy to identify it upon removal. It may become a problem, however, if someone is allergic to silicone.
Jul 11, '12
I work in BMT and in our inpatients we use almost exclusively temporary CVLs. If they're an auto transplant with a Mediport they get to keep it. Allos with mediports get them pulled before their transplant. Once they're preparing for discharge if they have a Mediport we just pull the TCVL. If they don't, they'll usually thread over a double lumen Hickman for discharge, unless the patient requests a PICC instead.
We don't use Heparin (if that's what you mean by "lock solution") with our PICCs or CVLs at all, only with ports, every time they're deaccessed or minimally once monthly.
Jul 14, '12
The type of catheter used highly depends upon the type and length of therapy that is prescribed. PICCs are the most commonly used form of advanced vascular access due to their low risk/low cost nature but implanted ports are used more often for long term aggressive therapies.
There is no standard locking solution, some places use heparin but most reserve heparin for use with implanted ports. The use of heparin is diminishing in favor of normal saline due to the cost and lack of proven efficacy of it's use.