PICC TKO Rate?

[nicucourtney]

I was wondering if anyone had policies regarding the TKO rate for PICC's once the baby is currently on full feeds. We have a couple different methods and I am hoping to standardize the way we keep these tiny lines open including:

- 1 ml/hr on buretrol pump (with bag of fluid)
- 2 ml/hr on buretrol pump
- 1 ml/hr on syringe pump

Our theory is that with the consistent pressure on the syringe pump, the rate can be decreased. I have yet to see a PICC clot off with any of these methods, but am wondering what other NICUs are doing!

Thanks
Courtney

[Stefan Johansson]

We almost always use syringe pumps (for all drips, drugs etc) and keep a rate of 0.8-1.0 ml/hr. We add 20 units of heparin / 100 ml sodium chloride.

My personal feeling is that it is rather the "age" of the PICC (nb of days it has been used) that determines if it will clot or not, than the infusion rate.

[JoannieO]

We use 1ml/hr on the Alaris infusion pump (with bag of fluid). We do not heparinize the fluid, and if the line is not needed for medications we take it out as soon as the baby is tolerating full feeds. We feel that if there is no need for the line, then it is just another portal for infection and is best removed.