Abstract
Background: Patients with chronic intestinal failure who require long-term parenteral nutrition rely on central venous catheters (CVCs) for access to nutrition and hydration. With prolonged use, complications such as central line–associated bloodstream infection (CLABSI), damage to CVC, and central venous thrombosis (CVT) can threaten the availability of life-preserving access. Because of this, all efforts should be made to preserve CVCs with techniques such as catheter salvage in case of CLABSI and catheter repair when damaged. The present study was conducted to evaluate the effectiveness and safety of catheter repair in our patient population. Methods: Retrospective review in 1253 adult patients who received home parenteral nutrition at the Mayo Clinic between September 1, 1997, and April 30, 2018, was conducted to determine the incidence of CLABSI and CVT in patients who underwent CVC repair. Results: Fifty-five CVC repairs were performed in 36 patients (n = 23 female) with mean age of 57.05 ± 16.96 years. A total of 14 catheters (25.45%) were complicated with 24 episodes of CLABSI. CLABSI rate before and after repair was 0.23/1000 catheter days and 0.21/1000 catheter days, respectively. Most common indications for eventual catheter replacement were mechanical damage (32%), infection (32%), and switching to alternate mode of nutrition (24%). We had a 100% success rate of catheter repair procedure, and no post-procedural complications were present. Conclusion: Catheter repair can increase the catheter survival without increasing the risk of CLABSI, providing not only socioeconomic benefit but also decreasing risk of compromising future vascular access.
| Original language | English (US) |
|---|---|
| Journal | Journal of Parenteral and Enteral Nutrition |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- catheter damage
- catheter repair
- central line–associated bloodstream infection
- central venous catheters
- CLABSI
- Hickman
- home parenteral nutrition
- nutrition
- parenteral nutrition
- venous access
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
Cite this
Repair of Central Venous Catheter in a Single-Center Adult Home Parenteral Nutrition Cohort. / Velapati, Saketh R.; Schroeder, Sara; Kuchkuntla, Aravind R.; Salonen, Bradley R.; Bonnes, Sara L.; Hurt, Ryan T; Mundi, Manpreet S.
In: Journal of Parenteral and Enteral Nutrition, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Repair of Central Venous Catheter in a Single-Center Adult Home Parenteral Nutrition Cohort
AU - Velapati, Saketh R.
AU - Schroeder, Sara
AU - Kuchkuntla, Aravind R.
AU - Salonen, Bradley R.
AU - Bonnes, Sara L.
AU - Hurt, Ryan T
AU - Mundi, Manpreet S.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Patients with chronic intestinal failure who require long-term parenteral nutrition rely on central venous catheters (CVCs) for access to nutrition and hydration. With prolonged use, complications such as central line–associated bloodstream infection (CLABSI), damage to CVC, and central venous thrombosis (CVT) can threaten the availability of life-preserving access. Because of this, all efforts should be made to preserve CVCs with techniques such as catheter salvage in case of CLABSI and catheter repair when damaged. The present study was conducted to evaluate the effectiveness and safety of catheter repair in our patient population. Methods: Retrospective review in 1253 adult patients who received home parenteral nutrition at the Mayo Clinic between September 1, 1997, and April 30, 2018, was conducted to determine the incidence of CLABSI and CVT in patients who underwent CVC repair. Results: Fifty-five CVC repairs were performed in 36 patients (n = 23 female) with mean age of 57.05 ± 16.96 years. A total of 14 catheters (25.45%) were complicated with 24 episodes of CLABSI. CLABSI rate before and after repair was 0.23/1000 catheter days and 0.21/1000 catheter days, respectively. Most common indications for eventual catheter replacement were mechanical damage (32%), infection (32%), and switching to alternate mode of nutrition (24%). We had a 100% success rate of catheter repair procedure, and no post-procedural complications were present. Conclusion: Catheter repair can increase the catheter survival without increasing the risk of CLABSI, providing not only socioeconomic benefit but also decreasing risk of compromising future vascular access.
AB - Background: Patients with chronic intestinal failure who require long-term parenteral nutrition rely on central venous catheters (CVCs) for access to nutrition and hydration. With prolonged use, complications such as central line–associated bloodstream infection (CLABSI), damage to CVC, and central venous thrombosis (CVT) can threaten the availability of life-preserving access. Because of this, all efforts should be made to preserve CVCs with techniques such as catheter salvage in case of CLABSI and catheter repair when damaged. The present study was conducted to evaluate the effectiveness and safety of catheter repair in our patient population. Methods: Retrospective review in 1253 adult patients who received home parenteral nutrition at the Mayo Clinic between September 1, 1997, and April 30, 2018, was conducted to determine the incidence of CLABSI and CVT in patients who underwent CVC repair. Results: Fifty-five CVC repairs were performed in 36 patients (n = 23 female) with mean age of 57.05 ± 16.96 years. A total of 14 catheters (25.45%) were complicated with 24 episodes of CLABSI. CLABSI rate before and after repair was 0.23/1000 catheter days and 0.21/1000 catheter days, respectively. Most common indications for eventual catheter replacement were mechanical damage (32%), infection (32%), and switching to alternate mode of nutrition (24%). We had a 100% success rate of catheter repair procedure, and no post-procedural complications were present. Conclusion: Catheter repair can increase the catheter survival without increasing the risk of CLABSI, providing not only socioeconomic benefit but also decreasing risk of compromising future vascular access.
KW - catheter damage
KW - catheter repair
KW - central line–associated bloodstream infection
KW - central venous catheters
KW - CLABSI
KW - Hickman
KW - home parenteral nutrition
KW - nutrition
KW - parenteral nutrition
KW - venous access
UR - http://www.scopus.com/inward/record.url?scp=85067051888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067051888&partnerID=8YFLogxK
U2 - 10.1002/jpen.1611
DO - 10.1002/jpen.1611
M3 - Article
C2 - 31155738
AN - SCOPUS:85067051888
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
SN - 0148-6071
ER -