Home Parenteral Nutrition: Vascular Access and Related Complications

Nutr Clin Pract. 2017 Dec;32(6):769-776. doi: 10.1177/0884533617734788. Epub 2017 Oct 12.

Abstract

Patients with chronic intestinal failure are dependent on parenteral nutrition (PN) to maintain health and preserve life. Maintaining safe vascular access is vital to prevent life-threatening complications such as catheter-related bloodstream infection or central venous occlusion. Dedicated central venous catheters with rigorous catheter care aseptic protocols are vital in obtaining good long-term outcomes that allow continuation of PN over many years. Good catheter care requires an experienced multidisciplinary team using appropriate vascular devices, trained to identify and aggressively treat catheter-related bloodstream infections, catheter occlusions, and catheter-related thrombosis. Consideration must also be given to evolving strategies to prevent recurrent infections, including prophylactic central venous catheter locks.

Keywords: catheter-related infections; central venous catheters; home care services; home nutrition support; nutritional support; parenteral nutrition; vascular access devices.

Publication types

  • Review

MeSH terms

  • Bacteremia / etiology
  • Bacteremia / prevention & control*
  • Catheter Obstruction / adverse effects
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / prevention & control*
  • Central Venous Catheters / adverse effects*
  • Humans
  • Incidence
  • Intestinal Diseases / etiology
  • Intestinal Diseases / prevention & control*
  • Parenteral Nutrition, Home / adverse effects*
  • Risk Factors
  • Thrombosis / etiology
  • Thrombosis / prevention & control*