scholarly journals American Society for Parenteral and Enteral Nutrition Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration

2018 ◽  
Vol 43 (1) ◽  
pp. 15-31 ◽  
Author(s):  
Debra S. Kovacevich ◽  
Mandy Corrigan ◽  
Vicki M. Ross ◽  
Liam McKeever ◽  
Amber M. Hall ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Central Venous Access ◽  
Venous Access ◽  
Home Parenteral Nutrition ◽  
Central Venous ◽  
Nutrition Guidelines ◽  
American Society ◽  
Venous Access Devices

Tip Position of Long-Term Central Venous Access Devices Used for Parenteral Nutrition

2007 ◽  
Vol 31 (5) ◽  
pp. 382-387 ◽  
Author(s):  
Robert DeChicco ◽  
Douglas L. Seidner ◽  
Carlos Brun ◽  
Ezra Steiger ◽  
Judy Stafford ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Tip Position ◽  
Venous Access Devices

scholarly journals Non-Antibiotic Antimicrobial Catheter Lock Solutions in Patients on Home Parenteral Nutrition

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1165 ◽  
Author(s):  
Jessica Noelting ◽  
Brian Jurewitsch ◽  
Johane Allard
Keyword(s):  
Parenteral Nutrition ◽  
Central Venous Access ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Home Parenteral Nutrition ◽  
Microbial Colonization ◽  
Central Venous ◽  
New Methods ◽  
Catheter Lock

Patients on home parenteral nutrition (HPN) are dependent on central venous access for long-term sustenance, and catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity and mortality in this patient population. As such, there is much interest in finding new methods for preventing CRBSIs in patients on HPN. As it is thought that these infections are preceded by microbial colonization of the catheter, one approach is to use antimicrobial catheter lock solutions. Although antibiotic catheter lock solutions have been present for decades, their use has been mostly limited to the treatment of CRBSIs due to concern for promoting microbial resistance. Recently, however, with the advent of non-antibiotic antimicrobial catheter lock solutions, this approach is gaining popularity as a promising method to decrease rates of CRBSI in HPN patients.

Use of an Intercostal Vein for Central Venous Access in Home Parenteral Nutrition: A Case Report

1986 ◽  
Vol 10 (6) ◽  
pp. 659-661 ◽  
Author(s):  
David Lammermeier ◽  
Ezra Steiger ◽  
Delos Cosgrove ◽  
Margaret Zelch
Keyword(s):  
Case Report ◽  
Parenteral Nutrition ◽  
Central Venous Access ◽  
Venous Access ◽  
Home Parenteral Nutrition ◽  
Central Venous

Efficacy of 4% tetrasodium ethylenediaminetetraacetic acid (T-EDTA) catheter lock solution in home parenteral nutrition patients: A quality improvement evaluation

2020 ◽  
pp. 112972982094691
Author(s):  
Jocelyn Hill ◽  
Rachel Garner
Keyword(s):  
Parenteral Nutrition ◽  
Ethylenediaminetetraacetic Acid ◽  
Central Venous Access ◽  
Venous Access ◽  
Home Parenteral Nutrition ◽  
Central Venous ◽  
Post Intervention ◽  
Central Venous Access Device ◽  
Access Device ◽  
Venous Access Device

Introduction: A functioning and reliable central venous access device is fundamental for home parenteral nutrition patients to administer essential nutrition. Complications of central venous access devices including occlusion, microbial colonization, and biofilm formation are problematic and sometimes life-threatening. A novel lock solution, 4% tetrasodium ethylenediaminetetraacetic acid, has properties that may reduce such complications. Purpose: The aim of this study was to determine the safety, efficacy, and cost implications of implementing 4% tetrasodium ethylenediaminetetraacetic acid to prevent catheter-related complications in home parenteral nutrition patients. Methods: A pre- and post-intervention study was carried over 36 months (12 months pre; 24 months post) by the British Columbia Home Parenteral Nutrition Program in Vancouver, Canada, where 4% tetrasodium ethylenediaminetetraacetic acid was implemented for patients at high risk for central venous access device occlusion and catheter-related infection. Patients were included in the study if they had previous central venous access device complications. The outcomes evaluated were central line-associated bloodstream infection, catheter occlusion requiring thrombolytic treatment, and catheter replacements. Results: In total, 22 out of 105 patients met the inclusion criteria. Two patients were excluded from analyses due to non-adherence and concomitant use of other lock solutions. Post intervention, 20 home parenteral nutrition patients experienced significant reduction in the central line-associated bloodstream infection rate (pre = 1.918/1000 catheter days; post = 0.563/1000 catheter days; p = 0.04) There were no occlusion events reported post intervention. Conclusion: For home parenteral nutrition patients, 4% tetrasodium ethylenediaminetetraacetic acid lock solution effectively reduces the risk of central venous access device complications including occlusions and catheter-related infections.

Upper Extremity Deep Venous Thrombosis in Cancer Patients with Venous Access Devices - Prophylaxis with a Low Molecular Weight Heparin (Fragmin)

1996 ◽  
Vol 75 (02) ◽  
pp. 251-253 ◽  
Author(s):  
Manuel Monreal ◽  
Antoni Alastrue ◽  
Miquel Rull ◽  
Xavier Mira ◽  
Jordi Muxart ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Upper Extremity ◽  
Statistical Significance ◽  
Central Venous Access ◽  
Venous Access ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
Central Venous ◽  
True Incidence ◽  
Venous Access Devices

SummaryCentral venous access devices are often essential for the administration of chemotherapy to patients with malignancy, but its use has been associated with a number of complications, mainly thrombosis. The true incidence of upper extremity deep vein thrombosis (DVT) in this setting is difficult to estimate since there are very few studies in which DVT diagnosis was based on objective tests, but its sequelae include septic thrombophlebitis, loss of central venous access and pulmonary embolism.We performed an open, prospective study in which all cancer patients who underwent placement of a long-term Port-a-Cath (Pharmacia Deltec Inc) subclavian venous catheter were randomized to receive or not 2500 IU sc of Fragmin once daily for 90 days. Venography was routinely performed 90 days after catheter insertion, or sooner if DVT symptoms had appeared. Our aims were: 1) to investigate the effectiveness of low doses of Fragmin in preventing catheter-related DVT; and 2) to try to confirm if patients with high platelet counts are at a higher risk to develop subclavian DVT, as previously suggested.On the recommendation of the Ethics Committee, patient recruitment was terminated earlier than planned: DVT developed in 1/16 patients (6%) taking Fragmin and 8/13 patients (62%) without prophylaxis (Relative Risk 6.75; 95% Cl: 1.05-43.58; p = 0.002, Fisher exact test). No bleeding complications had developed. As for prediction of DVT, there was a tendency towards a higher platelet count in those patients who subsequently developed DVT, but differences failed to reach any statistical significance (286 ±145 vs 207 ±81 X 109/1; p = 0.067). According to our experience, Fragmin at the dosage used proved to be both effective and safe in these patients.

Prevention of Infection in Adults Receiving Intravenous Antibiotic Treatment via Indwelling Central Venous Access Devices

2019 ◽  
Vol 14 (1) ◽  
pp. 47-49
Author(s):  
Basant K. Puri ◽  
Anne Derham ◽  
Jean A. Monro
Keyword(s):  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Central Venous Access ◽  
Case Series ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Host Cells ◽  
Central Venous ◽  
Intravenous Antibiotic ◽  
Venous Access Devices

Background: The use of indwelling Central Venous Access Devices (CVADs) is associated with the development of bloodstream infections. When CVADs are used to administer systemic antibiotics, particularly second- or higher-generation cephalosporins, there is a particular risk of developing Clostridium difficile infection. The overall bloodstream infection rate is estimated to be around 1.74 per 1000 Central Venous Catheter (CVC)-days. Objective: We hypothesised that daily oral administration of the anion-binding resin colestyramine (cholestyramine) would help prevent infections in those receiving intravenous antibiotic treatment via CVADs. Method: A small case series is described of adult patients who received regular intravenous antibiotic treatment (ceftriaxone, daptomycin or vancomycin) for up to 40 weeks via indwelling CVADs; this represented a total of 357 CVC-days. In addition to following well-established strategies to prevent C. difficile infection, during the course of the intravenous antibiotic treatment the patients also received daily oral supplementation with 4 g colestyramine. Results: There were no untoward infectious events. In particular, none of the patients developed any symptoms or signs of C. difficile infection, whereas approximately one case of a bloodstream infection would have been expected. Conclusion: It is suggested that oral colestyramine supplementation may help prevent such infection through its ability to bind C. difficile toxin A (TcdA) and C. difficile toxin B (TcdB); these toxins are able to gain entry into host cells through receptor-mediated endocytosis, while anti-toxin antibody responses to TcdA and TcdB have been shown to induce protection against C. difficile infection sequelae.

A Psychometric Validation of the Decisional Conflict Scale in Italian Cancer Patients Scheduled for Insertion of Central Venous Access Devices

2020 ◽  
Vol 40 (10) ◽  
pp. 5583-5592
Author(s):  
MARIA ROSARIA ESPOSITO ◽  
ASSUNTA GUILLARI ◽  
FRANCESCO GIANCAMILLI ◽  
TERESA REA ◽  
MICHELA PIREDDA ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Central Venous Access ◽  
Venous Access ◽  
Decisional Conflict ◽  
Psychometric Validation ◽  
Central Venous ◽  
Decisional Conflict Scale ◽  
Venous Access Devices ◽  
Conflict Scale
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