Drawing Blood Samples From Picc Line - Nursing The Neonate - 99nicu

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Aedi Budi Dharma

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Aedi Budi Dharma Member

July 25, 20205 yr

July 25, 20205 yr

Greetings everyone

Do you draw blood samples from PICC line?

 

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Stefan Johansson

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Stefan Johansson Administrators

July 28, 20205 yr

July 28, 20205 yr

We practically only use our PICC lines for parenteral nutrition. The small diameter (28G) only makes it possible to infuse only. 

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99nicu.org

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July 28, 20205 yr

July 28, 20205 yr From Twitter!

 

 

Aedi Budi Dharma

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July 28, 20205 yr

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July 28, 20205 yr

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Thank you very much indeed.

Stefan Johansson

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Stefan Johansson Administrators

July 28, 20205 yr

July 28, 20205 yr

More from Twitter! @Aedi Budi Dharma - as reply to your question about blood products, we don't use PICC lines for plasma or blood, the lumen of our PICC lines would clot.

 

 

 

 

 

Guest marcydf

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Guest marcydf Guests

July 28, 20205 yr

comment_10851 July 28, 20205 yr comment_10851

When i was in troubles I did blood samples through 24G lines. Then I washed with 2 U of heparin/ml saline. Never used for any transfusion. 

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Helmut

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Helmut Member

August 9, 20205 yr

August 9, 20205 yr

Considering hygiene you should not do it, but I do it

1. if I need a blood culture and the line may be responsible for the infection,

2. if I need blood and the PICC line is about to be withdrawn,

3. in emergencies.

The technique is to withdraw with a 1 ml syringe using a constantly changing negative pressure of 0,5 ml maximum. Stop if the blood column does not move constantly (and slowly) and immediately flush with a prepared saline syringe. It works 90% of the time.

Erythrocytes are a lot smaller (7,5µm) than the inner diameter of a PICC line (28G = 1Fr has 0,17mm = 170µm). A study has shown that you can give blood via a PICC line without hemloysis (Pediatr Crit Care Med. 2004 Jan;5(1):69-74. PMID: 14697112).  See also nice experiments in https://chartermedical.com/wp-content/uploads/2015/09/TexasChildrensPDF.pdf. There it is stated that you should not do it with platelets because of clotting.

In an emergency we gave 80 ml FFP via 28G PICC line with no problems. It needs a pump with pressure cut of set to max - you can not do it by hand.

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