Peripherally Inserted Central Catheter (PICC) Complications During Pregnancy

Cape, Alison; Mogensen, Kris M.; Robinson, Malcolm K.; Carusi, Daniela

doi:10.1177/0148607113489994

Cited by 29 publications

(19 citation statements)

References 21 publications

(29 reference statements)

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“…The concern is primarily due to a higher rate of catheter-related complications among pregnant women. 187 A retrospective study including 94 women with HG found neither EN nor PN to be superior in achieving healthy birth outcomes compared with those receiving IV medications only. Additionally, 64% of the participants with a peripherally inserted central catheter (PICC) line suffered complications, such as bacteremia, thrombosis, and pulmonary embolus, though it should be noted that only 5 of the 33 women with a PICC were receiving PN.…”

Section: Enteral and Parenteral Nutritionmentioning

confidence: 99%

“…PN in HG should be reserved for those unable to maintain weight who failed EN or have contraindications. The concern is primarily due to a higher rate of catheter‐related complications among pregnant women . A retrospective study including 94 women with HG found neither EN nor PN to be superior in achieving healthy birth outcomes compared with those receiving IV medications only.…”

Section: Nutritionmentioning

confidence: 99%

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Hyperemesis Gravidarum

2018

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Nausea and vomiting of pregnancy affect the majority of pregnancies, while the most severe version, hyperemesis gravidarum (HG), affects a much smaller subset of women. Despite the prevalence of nausea and vomiting of pregnancy and the severe consequences of HG, the pathophysiology of these conditions is not fully understood. Currently, it is thought that a combination of hormonal factors accounts for their development. Multiple treatments have been described for nausea and vomiting of pregnancy and HG with varying levels of success. In this paper we describe the epidemiology of nausea and vomiting of pregnancy and HG, the recommended workup, their proposed etiologic factors, treatments, and their potential impact on mother and baby.

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Section: Enteral and Parenteral Nutritionmentioning

confidence: 99%

Section: Nutritionmentioning

confidence: 99%

Hyperemesis Gravidarum

2018

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“…Larger‐caliber CVADs are also more likely than smaller devices to create conditions that lead to thrombus formation, such as endothelial trauma, inflammation, stasis, and turbulent blood flow 22 . The risk for DVT is especially pronounced with PICCs as compared with other types of CVADs, particularly for patients who are critically ill, who are pregnant, or who have cancer 36 , 37 . One analysis of 2014 PICCs revealed that triple‐lumen devices carried a 20‐fold increase in risk for DVT when compared with single‐lumen PICCs 38 …”

Section: Question 5: What Factors Play a Role In Selecting And Placinmentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

176

202

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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“…A significant maternal complication rate (66.4%) associated with the use of PICCs also was noted in a retrospective study of 33 women with hyperemesis gravidarum and included infection, thromboembolism, bacteremia, and sepsis (94). Similarly, another retrospective study of 66 pregnant women with hyperemesis who received PICCs for intravenous fluid, parenteral nutrition, and antibiotic administration also found complications in 55.9% of PICCs (102). The overall complication rate was 18.5 per 1,000 PICC days; bacteremia was the most frequent major complication occurring at a rate of 20.2% of major complications.…”

Section: The Following Recommendations Are Based Primarily On Consensmentioning

confidence: 78%

Practice Bulletin No. 153

2015

Obstetrics & Gynecology

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Committee on Practice Bulletins-Obstetrics. This Practice Bulletin was developed by the Committee on Practice Bulletins-Obstetrics with the assistance of T. Murphy Goodwin, MD, and Susan M. Ramin, MD. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice.

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Peripherally Inserted Central Catheter (PICC) Complications During Pregnancy

Cited by 29 publications

References 21 publications

Hyperemesis Gravidarum

Hyperemesis Gravidarum

When Is Parenteral Nutrition Appropriate?

Practice Bulletin No. 153

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