Repair of Central Venous Catheters in Home Parenteral Nutrition Patients

Salonen, Bradley R.; Bonnes, Sara L.; Mundi, Manpreet S.; Lal, Simon

doi:10.1002/ncp.10262

Cited by 10 publications

(14 citation statements)

References 22 publications

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“…Figure 1 illustrates components of a single‐lumen silicone CVC. The steps of permanent repair of a damaged CVC have been previously described 16 . A temporary CVC repair can be performed short‐term (for <24 hours) to assess and address concerns about CVC patency and/or to provide intravenous (IV) access for hydration until a permanent repair can be performed.…”

Section: Methodsmentioning

confidence: 99%

Impact of central venous catheter repair in pediatric intestinal failure

Santhana

Davis

Rahhal

2021

J Parenter Enteral Nutr

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Objectives Patients with intestinal failure (IF) require long‐term parenteral nutrition through central venous catheters (CVCs). When damaged, catheter replacement or repair is considered. Limited literature exists on repair outcomes in this population. We aimed to assess the impact of repair on durability of exiting CVCs and infection rates. Methods This was a retrospective cohort study of pediatric IF patients with tunneled silicone CVCs over 10 years. Outcomes were evaluated by assessing CVC longevity, repair success, replacement, and postrepair infection rates. Results One hundred thirty‐eight repairs and 45 replacements were conducted in 37 patients with repair and replacement rates of 4.7 and 1.5 per 1000 catheter days, respectively. Twenty patients (54%) required ≥1 repair. For CVCs requiring repair, median CVC durability without and with repairs were at 123 and 391 days, respectively (P < .0001). Overall repair success rate was 96% with significantly lower success in the emergency department at 81% (P = .007). The 7‐day postrepair infection rate was 2.2% without specific risk factors identified. Most repairs (76%) were performed by the Pediatric Gastroenterology division. Variability in practice was noted among services, including frequency of periprocedural antibiotic use and performance of temporary repairs before permanent repairs. A gradual increase in CVC repair rate was noted over time. Conclusions Our study showed that CVC repair is effective in prolonging CVC durability in pediatric IF patients without increasing infection rates. Incorporating a temporary repair as a step before permanent repair may offer a route to address potential intraluminal thrombosis before permanent repair.

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Section: Methodsmentioning

confidence: 99%

Impact of central venous catheter repair in pediatric intestinal failure

Santhana

Davis

Rahhal

2021

J Parenter Enteral Nutr

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“…33 We have described our repair protocol in detail previously. 31,34 At the time of our last review, 55 CVC repairs in 36 patients had taken place at our center. 31 At the time of repair, the median duration and range the CVC had been in place was 895 days (416-1640 days).…”

Section: Catheter Damage and Repairmentioning

confidence: 99%

“…Image of damaged catheter before repair. Adapted with permission from Salonen et al 34 F I G U R E 3 Repaired catheter with adhesive being inserted underneath the sheath. Adapted with permission from Salonen et al 34 when possible.…”

Section: If-associated Liver Diseasementioning

confidence: 99%

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Management of long‐term home parenteral nutrition: Historical perspective, common complications, and patient education and training

Mundi

Elfadil

Hurt

et al. 2022

J Parenter Enteral Nutr

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Intestinal failure (IF) is a rare disease that requires ongoing intravenous supplementation to sustain growth and health. Advancements in parenteral nutrition (PN) and central venous access in the 1960s and 1970s transformed a life-limiting disease to a chronic one in which patients are able to administer hydration, electrolytes, micronutrients, and macronutrients in the comfort of their home. However, despite ongoing advancements in the field of home PN (HPN), complications-whether related to central venous catheters or PN itself-remain common and can be associated with significant morbidity and mortality. Central venous access can be associated with thrombosis, central line-associated bloodstream infection, or damage and can result in loss of access over time. PN can be associated with IF-associated liver disease or hyperglycemia. The key to preserving central venous access and quality of life and maintaining health for patients with chronic IF (CIF) is education focused on prevention and prompt management of CIF complications as they arise. This education typically takes place at the time of initiation of HPN, either in the hospital setting or in the patient's home. The present manuscript describes the historical progression of HPN, prevalence and characteristics of CIF, and an in-depth discussion of the most common catheter-related and PN-related complications and their management, along with a discussion of our education and training process.

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“…In terms of the type of CVC used for PN administered centrally, three main types are used: peripherally inserted central catheter (PICC), tunneled CVC, or an implanted port [20]. The choice of CVC used should be individualized for each patient.…”

Section: Understanding Parenteral Nutritionmentioning

confidence: 99%

The Role of Parenteral Nutrition for Incurable Cancer: Bridging Expectations and Reality

et al. 2021

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Purpose of ReviewIn this review, we examine the role for parenteral nutrition (PN) for nutritional support of patients with advanced, incurable cancer with an emphasis on bridging the divide between expectations and reality.Recent Findings As the rates of cancer have continued to rise worldwide, the utility of PN has continued to be studied. Due to multiple reasons, high-quality research studies have been scarce, and much of the data is based on observational studies. The recent trend appears to support the use of PN in carefully selected patients. Importantly, the effect on quality of life also should be considered when deciding to initiate PN. Summary PN can be a supportive lifeline for patients with advanced, incurable cancer. The medical team should consider each patient individually to decide if PN should be offered. It is of paramount important for the medical team to engage in shared decision-making with the patient and caregiver(s) to ensure that PN is aligned with their goals and wishes.

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Repair of Central Venous Catheters in Home Parenteral Nutrition Patients

Cited by 10 publications

References 22 publications

Impact of central venous catheter repair in pediatric intestinal failure

Impact of central venous catheter repair in pediatric intestinal failure

Management of long‐term home parenteral nutrition: Historical perspective, common complications, and patient education and training

The Role of Parenteral Nutrition for Incurable Cancer: Bridging Expectations and Reality

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