Repair of Central Venous Catheter in a Single-Center Adult Home Parenteral Nutrition Cohort

Saketh R. Velapati, Sara Schroeder, Aravind R. Kuchkuntla, Bradley R. Salonen, Sara L. Bonnes, Ryan T Hurt, Manpreet S. Mundi

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalJournal of Parenteral and Enteral Nutrition
DOIs
StatePublished - Jan 1 2019

Fingerprint

Home Parenteral Nutrition
Central Venous Catheters
Catheters
Infection
Venous Thrombosis
Parenteral Nutrition
Blood Vessels

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 journalArticle

Velapati, Saketh R. ; Schroeder, Sara ; Kuchkuntla, Aravind R. ; Salonen, Bradley R. ; Bonnes, Sara L. ; Hurt, Ryan T ; Mundi, Manpreet S. / Repair of Central Venous Catheter in a Single-Center Adult Home Parenteral Nutrition Cohort. In: Journal of Parenteral and Enteral Nutrition. 2019.
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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.",
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AU - Kuchkuntla, Aravind R.

AU - Salonen, Bradley R.

AU - Bonnes, Sara L.

AU - Hurt, Ryan T

AU - Mundi, Manpreet S.

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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.

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KW - parenteral nutrition

KW - venous access

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