Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy

Abstract Catheter-related central venous thrombosis is a serious complication in patients who need long-term venous access. Though scientific data and clinical experience are steadily increasing, many uncertainties still exist about several aspects of this complication, including etiology, pathogenesis, diagnosis, management, and prevention of this complication. The GAVeCeLT (the Italian Study Group for Long Term Central Venous Access) promoted a nationwide consensus, and 12 experts reviewed systematically all the available literature. A preliminary document was presented and discussed during a specific Consensus Meeting, in front of a panel of more than 80 experts (representing different health professions and disciplines). This led to a prefinal document, which was presented to more than 800 health professionals. After peer review by an external board of experts, the final document was prepared. In this article, methodology and results of the consensus are presented.

Download Full-text

Central venous thrombosis in patients receiving long-term parenteral nutrition

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-153 ◽

2008 ◽

Vol 33 (1) ◽

pp. 32-38 ◽

Cited By ~ 8

Author(s):

Donald R. Duerksen

Keyword(s):

Parenteral Nutrition ◽

Venous Thrombosis ◽

Vitamin K ◽

Central Venous Access ◽

Anticoagulation Therapy ◽

Venous Catheter ◽

Venous Access ◽

Central Venous ◽

Central Venous Thrombosis

Long-term parenteral nutrition (PN) is administered to patients who are unable to use their gastrointestinal tract to absorb sufficient nutrients and water to maintain their nutritional status. Patients receiving long-term parenteral nutrition are at risk of numerous complications including thrombosis of the central venous catheter used to provide nutrition. Central venous access is essential to the successful delivery of long-term PN. One of the strategies to lessen the frequency of this complication is anticoagulation therapy with warfarin. The effect of warfarin in preventing this complication may be modified by vitamin K intake. Individuals with gastrointestinal failure may receive vitamin K from a variety of sources. This review summarizes the role of warfarin in preventing central venous access thrombosis. It also summarizes potential sources of vitamin K intake in home parenteral nutrition patients, examines the evidence for recommendations regarding vitamin K intake, and considers the potential impact of increased vitamin K intake on home PN patients, particularly on the prevention of central venous thrombosis.

Download Full-text