CVC blood flow rate

[bella706]

I was wondering if anyone knew what you should set the bloodflow rate at when running a patient via a CVC line when you have to reverse the lines due to poor flow. Someone told me that you shouldn't run it faster than like 250ml/min due to increased recirculation with reversed arterial/venous lines, but no one else I have asked has ever heard of this being a standard practice. So if the ordered flow rate is 400ml/min, and say the arterial line will not withdraw (thus the need to reverse the lines), and when I reverse the lines the flow is great (so it is possible to achieve 400ml/min if I choose) what should I set the flow at so that the patient gets the optimal dialysis?

[pricklypear]

We run ours up to 400 - whether the lines are reversed or not.

[Lacie, BSN, RN]

We run ours up to 400 - whether the lines are reversed or not.

Same here. We try to avoid reversal but sometimes it's not an option until we can get intervention. Many units doing away with Activase/cathflo these days due to cost also. I always understood that under 250 meant need for immediate intervention as the preferance is no less than 350. At least the opinion with the clinics I've been associated with.

[GeauxNursing]

whatever is doctor's order, as tolerated.