WHAT IS A TRIFUSION-TRIPLE LUMEN CATHETER?
Hickman Trifusion triple lumen catheter is a central venous catheter made of polyurethane. The catheter is a long-term catheter used for collecting blood samples and administering drugs. One end of the catheter is placed in a large vessel near your heart and the other end exits below the collar bone.
The catheter comes with a tissue in growth cuff that keep the catheter fixed in a subcutaneous tunnel. It has three large lumens that are of equal size and appropriate for apheresis. The proximal lumen is used for blood products and the distal lumen for blood return during the procedure of apheresis.
Trifusion triple lumen central venous catheter can be used for both long-term and short-term venous access. It is used in the following situations;
- Obtaining blood samples frequently
- Intravenous infusion therapy
- Administration of fluids, drugs and blood products.
- Parenteral nutrition
- The catheter should not be used in the presence of a catheter related infection
- Allergiy to materials of which the catheter is made
- Previous episode of venous thrombosis
PLACEMENT AND REMOVAL OF TRIFUSION CATHETER
The catheter is placed in one of the large veins such that one end of the catheter open is the superior vena cava (SVC) right above the right atrium of heart. The catheter is inserted into the axillary-subclavian vein percutaneously such that it doesn’t enter the subclavian vein medially. If it enters medially, there are chances of catheter compression between first rib and clavicle.
It is then tunneled under the skin towards the exit site. The cuff attached to catheter is responsible for keeping the catheter in place and is placed in the tunnel 3-5cms below the exit site.
Since the retention cuff encourages tissue growth, the catheter needs to be removed surgically. Once the cuff is freed, the catheter can be removed easily by a gentle pull.
Just like all the other central venous catheters, trifusion could put a patient at risk of several complications. Here are a few of the complications;
- Air embolism
- Catheter related infection
- Cardiac arrhythmias
- Catheter or cuff erosion through skin
- Pneumothorax and haemothorax
- Catheter related sepsis
Since the catheter invades body, it has the potential of causing serious infections and complications that could lead to patient morbidity and mortality. Proper hygiene while inserting, examining, changing dressing and removing catheter is of immense importance.
In case of any redness, swelling, bruising and extrvasation all fluids should be discontinued and appropriate medical therapy started. Make sure that dressing remains dry and is firmly secured to the area so that catheter remains in position and is protected from infection.
Catheter should be regularly monitored for any kind od famage, since this could be a potential source of rupture, fragmentation and later embolism.