Efficacy of same venous route Hickman catheter replacement in patients with intestinal failure

Chee-Chee Koh; Huang-Wen Tsai; Siu-Chung Ha; Ya-Hui Tsai; Yun Chen

doi:10.1016/j.jfma.2022.10.003

Efficacy of same venous route Hickman catheter replacement in patients with intestinal failure

J Formos Med Assoc. 2023 May;122(5):419-426. doi: 10.1016/j.jfma.2022.10.003. Epub 2022 Oct 28.

Authors

Chee-Chee Koh¹, Huang-Wen Tsai², Siu-Chung Ha³, Ya-Hui Tsai³, Yun Chen⁴

Affiliations

¹ Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei 220, Taiwan.
² Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei 220, Taiwan; Graduate Institute of Medicine, Yuan Ze University, Chung-Li, Taoyuan 320, Taiwan.
³ Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei 220, Taiwan; Department of Chemical Engineering and Materials Science, Yuan Ze University, Taiwan.
⁴ Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei 220, Taiwan; Graduate Institute of Medicine, Yuan Ze University, Chung-Li, Taoyuan 320, Taiwan. Electronic address: ychen@mail.femh.org.tw.

PMID: 37096641
DOI: 10.1016/j.jfma.2022.10.003

Abstract

Background/purpose: Periodical replacement of venous Hickman catheters is required for the nutritional care of patients with intestinal failure. The conventional de novo operation (DN-OP) involves inserting the catheter into a new venous tract in each replacement; however, this could result in fast consumption of functional central vessels in patients with intestinal failure. Recently, same-route operation (SR-OP) has been adopted as an alternative approach for retaining venous access.

Methods: We conducted a retrospective study to compare the efficacy of Hickman catheters and the survival of venous vessels using two different operative strategies.

Results: Overall, 181 catheters were inserted, 109 using DN-OP and 72 using SR-OP. The mean catheter duration was 11.9 ± 8.8 months in the DN-OP group and 10.5 ± 5.6 months in the SR-OP group; the infection rate was 0.74 in the DN-OP group and 0.44 in the SR-OP group. The vein accesses used in these insertions (n = 113) were classified: the DN-vein group for veins accessed only by DN-OP (n = 75) and the SR-vein group for veins accessed by an initial DN-OP and subsequent SR-OPs (n = 38). Mean working duration per vein access was 12.3 ± 10.1 months in the DN-vein group and 28.2 ± 14.8 months in the SR-vein group (p < 0.001); mean infection-free duration was 11.4 ± 10.1 months in the DN-vein group and 27.7 ± 15.3 months in the SR-vein group (p < 0.001).

Conclusion: Application of SR-OP in Hickman catheter replacement significantly extended the working duration of venous access by re-using the same venous route without compromising catheter efficacy in patients with IF having poor venous access.

Keywords: Catheterization; Central venous; Intestinal failure; Retrospective study.

MeSH terms

Catheterization, Central Venous*
Central Venous Catheters*
Humans
Intestinal Failure*
Retrospective Studies