Prevention and treatment of implanted central venous catheter (CVC) - related sepsis: A report after six years of home parenteral nutrition (HPN)

Santarpia, Lidia; Pasanisi, Fabrizio; Alfonsi, L.; Violante, G.; Tiseo, D; Simone, Giovanni de; Contaldo, Franco

doi:10.1054/clnu.2002.0541

Cited by 87 publications

(81 citation statements)

References 19 publications

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“…Seeing these heterogeneous results and classifying the very high percentage of port patients in our study (94.4%) as a German peculiarity, the discussion of this aspect is quite difficult. Indeed, the incidence of CVC-related infections found in a sample with 69.27% port patients [16] was considerable higher than our one. But one of the authors' main conclusions was that training and experience were likely to reduce CVC-related infections.…”

Section: Discussioncontrasting

confidence: 77%

“…Since our data are based on a sample of 90.7% patients with malignancies, they should be comparable to those found in studies with a high percentage of oncological patients. These studies [8,16,18,20] reported CVC-related infections of 0.60-5.36 infections per 1,000 catheter days, where 3 of them found lower [8,20] or similar [18] incidences compared to our estimate of 1.02 infections per 1,000 catheter days. Even the type of catheter has been discussed as risk factor for CVC-related complications.…”

Section: Discussionsupporting

confidence: 52%

“…Even the type of catheter has been discussed as risk factor for CVC-related complications. Whereas some studies [10,20] found no difference in the incidence of CVC-related infections between the externally tunnelled type of CVC (Hickman/Broviac) and the implanted (Port-a-cath) type, others reported a significantly lower incidence in patients with externally tunnelled systems [8,16] or with implanted port catheters [21]. Seeing these heterogeneous results and classifying the very high percentage of port patients in our study (94.4%) as a German peculiarity, the discussion of this aspect is quite difficult.…”

Section: Discussionmentioning

confidence: 99%

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Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

et al. 2008

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Background: Home parenteral nutrition (HPN) has been shown to delay deterioration in cancer patients with malnutrition. Its risk-benefit ratio, however, is determined by the threat of central venous catheter (CVC) complications. Only few prospective studies on this subject exist, most of them based on small samples. The objective of this study was to provide reliable estimates of incidence rates of CVC complications in everyday HPN patient care in Germany. Patients and Methods: Aiming for a large prospective cohort study, we cooperated with a service provider caring for HPN patients nationwide. Between July 1 and November 30, 2006, all consecutive adult patients with more than 10 infusion days and no previous history of HPN were recruited. Follow-up ended on January 31, 2007. Data were collected in a standardised way by the provider’s staff. To prevent underreporting, we used computer-assisted telephone interviews with medical caregivers as a provider-independent data source. Results: 481 patients met the inclusion criteria, contributing a total of 31,337 catheter days. 52 patients experienced a total of 63 CVC complications, resulting in an incidence rate of 2.01 CVC complications per 1,000 catheter days including 1.02 CVC infections per 1,000 catheter days. Conclusion: HPN administration can be safely performed with a relatively low rate of CVC complications.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

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Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

et al. 2008

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“…Nevertheless in these difficult clinical circumstances HPN appears to be a reasonable safe intervention, provided that it is followed by a trained team (Santarpia et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Adult Home Parenteral Nutrition: a clinical evaluation after a 3-year experience in a Southern European centre

et al. 2005

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Results: In all, 140 (88%) were cancer and 19 (12%) noncancer patients. Main indications were carcinosis in 68 for total, and hypophagia/dysphagia in 62 patients for partial/integrative (to oral-enteral nutrition) HPN; mean duration of HPN was 81.457110.86 days of treatment and infection rate 2.89% in the whole population and 2.66% in the 36 patients treated for more than 3 months. No other major complications have been observed. Conclusion: HPN is confirmed to be a safe and effective treatment when prescribed and administered by a trained team.

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“…The prevention of CRB remains a significant challenge because of the associated high morbidity and mortality [2]. The incidence rate ranges from 0.34 to 6 CRB episodes per 1,000 catheter days in some studies [3,4,5], and can reach 10.8 episodes per 1,000 catheter days [6] in others.…”

Section: Introductionmentioning

confidence: 99%

Preventing Catheter-Related Bacteremia with Taurolidine-Citrate Catheter Locks: A Systematic Review and Meta-Analysis

Liu

Deng

et al. 2014

Blood Purif

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Background: Preliminary evidence from some studies suggests that taurolidine-citrate locks decrease catheter-related bacteremia (CRB), which is a major cause of morbidity and mortality in patients using intravascular catheters. No previous study has sought to summarize existing evidence on the use of taurolidine-citrate locks. A systematic review and meta-analysis were undertaken to determine whether taurolidine-citrate was more effective than heparin in the prevention of CRB. Methods: The major English (PubMed, EBSCO, Web of Science and OVID) and Chinese (CBM, CNKI, VIP and Wanfang Data) healthcare databases were searched for randomized controlled trials comparing the efficacy and safety of taurolidine-citrate lock solution (TCLS) and heparin lock solution in the prevention of CRB. Results: Three studies involving 236 patients with a total of 34,984 catheter days were included. The use of TCLS significantly decreased the risk of CRB (relative risk = 0.47, 95% CI: 0.25-0.89) and Gram-negative bacterial infection. There was no significant difference in Gram-positive infections and exit-site infections. Conclusions: Catheter locking with TCLS reduced the risk of CRB and Gram-negative bacterial infection. Adverse events include thrombotic events.

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Prevention and treatment of implanted central venous catheter (CVC) - related sepsis: A report after six years of home parenteral nutrition (HPN)

Cited by 87 publications

References 19 publications

Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

Central Venous Catheter Complications during Home Parenteral Nutrition: A Prospective Pilot Study of 481 Patients with More than 30,000 Catheter Days

Adult Home Parenteral Nutrition: a clinical evaluation after a 3-year experience in a Southern European centre

Preventing Catheter-Related Bacteremia with Taurolidine-Citrate Catheter Locks: A Systematic Review and Meta-Analysis

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