Do you "foil" your lipid tubings?

Specialties NICU

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Specializes in NICU, Charge & Transport Nurse.

This is my first post so bear with me.

Does your unit require you to place aluminum foil (or other protective barrier) around your lipid tubings to protect from light? I have heard both ways on my unit we do "foil our lipids" but other surrounding hospitals do not. Does anyone have any current info on this? THANKS

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Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

Very interesting! In 14 years I have never heard of this practice. So nope, we don't. We do change our tubing every 24hrs that has lipids in it.

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Specializes in NICU, Charge & Transport Nurse.

We change it every 24 hours also.

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Any rationale behind that? :confused:

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Specializes in Pediatrics Only.

When I did my senior year clinical in the NICU they Did foil the lipid tubing - to protect it from light breaking down the lipids is what I was told.

I thought it was an odd practice- that was the only time I did NICU and I now do Peds so I havent seen it since, just wanted to add that I have seen it before. Which by the way, was in Pennsylvania.

-Meghan

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Specializes in NICU, Infection Control.

I have not seen that done. If possible, ask for the reference behind the practice. You know, evidence-based practice and all that.....

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Specializes in NICU, Charge & Transport Nurse.

it is thought; not proven, that exposure of lipid solution to phototherapy light may result in the formation of triglyceride hydroperoxides that may be harmful. http://www.espen.org/education/documents/A174-04PaedPNGuidel_lipids.pdf

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Specializes in NICU.

nope. we have non-DHEA lipid tubing (which almost no one actually uses), and we change any tubing running less than 10cc/h every 24 hours. So usually lipid tubing gets changed q24, and sometimes TPN on the smaller kiddos.

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Specializes in NICU, PICU, educator.

We had one attending that did that, but we stopped after a while...the tubing only has .2ml in it,so they figured it wasn't worth it.

Elizabell...I am curious as to the rationale behind not changing TPN every 24 hours....aren't they afraid of sepsis with the higher glucoses and AA being a feast for bacteria?

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Specializes in NICU.
We had one attending that did that, but we stopped after a while...the tubing only has .2ml in it,so they figured it wasn't worth it.

Elizabell...I am curious as to the rationale behind not changing TPN every 24 hours....aren't they afraid of sepsis with the higher glucoses and AA being a feast for bacteria?

Almost all the kids on TPN have either a central line or a PCVL - the theory is to leave the lowest injection cap alone as much as possible. We do all tubing changes sterilely (not a real word, I know). We run through tubing running at 10cc or above q72.

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Our NICU actually changes TPN every 72 hours, no matter the size. I dont work days, which is when they do tubing changes, and I am not sure about the lipids, but I really dont hink trhy change them but every 72 either. We also have all PICC's or other centrals and also dont detatch tubing unless absolutely necessary, and are suppose to use betadine on the injection ports when we do enter one. I know that our sepsis rates from central lines are very very low, according to a study our unit blood stream infections committee did.

Also, we do not foil our lipids. Havent heard of anyone in the surrounding NICUs doing it either.

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Specializes in NICU, Charge & Transport Nurse.

Thanks for the reply. :nono: I guess our unit needs to do a little more research on the subject. One of the nurses figured it up it takes about 3 minutes to foil one tubing. On adverage we do about 20 a night. That is about an hour a day just foiling lipids. 365 hours a year; which equals about 15 days of foiling lipids:doh: Makes you kinda wonder what else do we do needlessly.

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