Details

Autor(en) / Beteiligte

• Santacruz, Elisa
• Mateo-Lobo, Raquel
• Riveiro, Javier
• Nattero, Lia
• Vega-Piñero, Belén
• Lomba, Gema
• Sabido, Raquel
• Carabaña, Fátima
• Arrieta, Francisco J.
• Botella-Carretero, Jose I.

Titel

Infectious complications in home parenteral nutrition: A long-term study with peripherally inserted central catheters, tunneled catheters, and ports

Ist Teil von

• Nutrition (Burbank, Los Angeles County, Calif.), 2019-02, Vol.58, p.89-93

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Home parenteral nutrition (HPN) has become a common therapy, with tunneled central venous catheters (CVCs) being the preferred route of administration.•Peripherally inserted central catheters (PICCs) have been increasingly used but whether they should be preferred over other types of CVCs is still controversial.•In this study, we aimed to evaluate the catheter-related complications of CVC in patients receiving HPN.•In all, 151 patients received HPN for the 11-y study period; 83% with an underlying malignancy, and 170 CVCs were used.•This study found that single-lumen PICCs and Hickman catheters showed low infectious complications for administration of HPN.•Multilumen catheters showed higher rates of infections, as well as ports, so they should not be routinely used for HPN. Home parenteral nutrition (HPN) has become a common therapy, with tunneled central venous catheters (CVCs) being the preferred route of administration. Peripherally inserted central catheters (PICCs) have been used increasingly, but whether they should be preferred over other types of CVCs is still controversial. The aim of this study was to evaluate catheter-related complications of CVC in patients receiving HPN. All patients treated at our center for HPN from 2007 to 2017 were prospectively included. A specialized intravenous therapy team took care of these patients. Catheter-related bloodstream infections (CRBSI) were confirmed with positive, simultaneous, differential blood cultures drawn through the CVC and peripheral vein and then semiquantitative or quantitative culture of the catheter tip. In all, 151 patients received HPN during the 11-y study period. Of these patients, 95 were women (63%) and 55 were men (37%), with a mean age of 58 ± 13 y. Twenty-six were non-cancer patients (17%) and the remaining 125 patients had an underlying malignancy (83%). Regarding the CVC, 116 were PICCs, 18 Hickman, and 36 ports. Confirmed CRBSI per catheter-days showed 0.15 episodes per 1000 catheter-days for PICCs, 0.72 for Hickman, and 2.02 for ports. PICCs had less-confirmed CRBSIs per 1000 catheter-days than ports (φ = 0.54, P = 0.005), but no difference between PICCs and Hickman was found (φ = 0.32, P = 0.110). Confirmed episodes of CRBSI (2 versus 13%, χ2 = 6.625, P = 0.036) were more frequent with multilumen catheters. In our setting, single-lumen PICC and Hickman catheters showed low infectious complications.