New Dual Lumen PICCs

dawngloves, BSN, RN · Jun 21, 2006

We've been using those since the Kendall ones were recalled. I think a couple of docs said they were harder to pass, but as of recently I've heard no compaints. Must've been thier imagination.

BittyBabyGrower, MSN, RN · Jun 21, 2006

We have used them also...we love them, but the sometimes our infusion pumps don't due to the small lumens. Our NNP's love them, they haven't had any issues placing them!

LaNICUnurse · Jun 22, 2006

We have just started using them. I haven't yet placed one though. I like the idea of having more than one port.

The first one I dealt with had one port that wasn't working, though.

aimeern33 · Aug 20, 2007

We started using them several months ago and the nurses on my PICC team are still mad at me for switching from the BD PICC. This catheter is much stiffer and they feel is more difficult to thread past the shoulder. We also seem to be having more infiltrates of late. I am doing some investigating as to the root cause of this. I do know that in the past Kendall has has several recalls on these lines. Unfortunately as far as a double lumen goes there are not a lot of options.

LoveTheNICU · Aug 21, 2007

Our NNPs have recently started putting these dual lumen PICCs in some of our larger babies- not sure why they are choosing just the bigger ones, I haven't seen P/P on them at all yet. Mostly, they are wonderful, in that you don't have to stop your TPN to run a med and such. They have proven especially helpful with our pre-op cardiac kids, who are often lacking reliable access and have several drips going at once.

One problem we have noted is that the babies have a tendency to be able to twist the lines and cause an occlusion of the flow- somehow they can move enough to bend or tangle the line between where it comes out from under the occlusive dressing and where it attaches to the actual IV tubing, if that makes any sense. Then your pump alarms and you have to go untwist the darn thing. We've been devising creative taping methods in addition to the regular central line dressing to try and prevent this problem, LOL. However, it is a small price to pay to gain twice the access of our previous PICCs.

aimeern33 · Aug 21, 2007

I spoke with the company about our problem with infiltration and they said that you have to thread the catheter very slowly at small increments especially on micropreemies to avoid nicking the side of the vessel. She also recommended warming the vein before insertion to dilate it.

LilPeanut, MSN, RN, NP · Aug 24, 2007

I hate small gauge double lumens.

You can't infuse quickly through them, which is a problem in an emergency. I can't count the number of kids I couldn't give nacl boluses to because their double lumen picc wouldn't accept a flow high enough.

Gompers, BSN, RN · Aug 31, 2007

I'll have to check what brand we use, but some of our bigger, sicker kids (usually PPHN or post-op) have gotten double lumen lines recently. We use one lumen for TPN, Fentanyl drips, pressors, etc. The other lumen we run 0.9%NS with heparin and use it for everything else except I do believe they're too small for blood products. One tip - we've found that since the lumen is so small, that if fluids are running at our normal TKO rate of 0.5 cc/hr they tend to clot off! Once we started running them at a minimum of 1 cc/hr we've had better luck.

BittyBabyGrower, MSN, RN · Sep 3, 2007

Gompers, we use a cap from Vygon, it is a pressure cap (I can never remember if it is positive or negative LOL) on our double lumen piccs and uvcs....it prevents blood back up into the line, even when you enter it and it really does decrease the clotting issue. We have cut way back on the amount of fluids we run thru them and the amount of heparin we are giving our kids using these. It really works on the 28fr lumen caths!