Last monday a PICC line was inserted in my right arm for TPN. Due to vascular stenosis the PICC line was inserted only to my subclavian vein. The doctor told me to increase slowly the TPN infusion rate.
At the hospital I received 2 full bags of PPN with no problem and no pain. At home I received a first bag of TPN with no pain. The day after I had some blood return in the PICC so walked and slept with my arm in a weird position trying to prevent the return so I started feeling musculoskeletal pain in my armpit, while moving my arm. There was no problem of flow in the PICC line but the 2 night after I felt like while infusing TPN the armpit pain was worse with armpit pain while moving my right arm at night and the pain getting better in the morning (still on TPN) and better while not infusing TPN.
There's no change in color of the arm, no swelling, no bleeding or discharge in the PICC entry site, no pain in the chest or anywhere else but the in armpit while pressing on it or moving the arm. No feeling of palpable cord in the armpit. I had no fever and I'm taking good care of the PICC line changing the dressing, washing it with saline regularly and keeping everything very sterile.
My question is was could worsen such pain while on TPN? could it be chemical phlebitis in the subclvian?