Infectious complications in home parenteral nutrition: A long-term study with peripherally inserted central catheters, tunneled catheters, and ports

Peripherally inserted central catheters provide access to the central chest veins and allow administration of long-term antibiotics, chemotherapy, blood products, fluids, and parenteral nutrition. Peripherally inserted central catheters provide an essential function and are routinely placed safely, but are not without risks. This case describes an unusual complication of peripherally inserted central catheter perforation into the pericardial space with subsequent successful percutaneous removal.

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SUN-P201: Comparison of Catheter-Related Complications with HickmanTM Catheters, Subcutaneous Ports and Peripherally Inserted Central Catheters in patients with Intestinal Failure Receiving Home Parenteral Nutrition

Clinical Nutrition ◽

10.1016/s0261-5614(16)30544-1 ◽

2016 ◽

Vol 35 ◽

pp. S119

Author(s):

F. Novak ◽

P. Kralova ◽

E. Meisnerova

Keyword(s):

Parenteral Nutrition ◽

Intestinal Failure ◽

Home Parenteral Nutrition ◽

Peripherally Inserted Central Catheters ◽

Central Catheters

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Faculty Opinions recommendation of Comparison of complications associated with peripherally inserted central catheters and Hickman™ catheters in patients with intestinal failure receiving home parenteral nutrition. Six-year follow up study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725719173.793541549 ◽

2018 ◽

Author(s):

Simon Lal

Keyword(s):

Parenteral Nutrition ◽

Intestinal Failure ◽

Home Parenteral Nutrition ◽

Peripherally Inserted Central Catheters ◽

Follow Up Study ◽

Central Catheters

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Peripherally Inserted Central Catheters for Long-term Parenteral Nutrition in Infants With Intestinal Failure

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0b013e3182801e7b ◽

2013 ◽

Vol 56 (5) ◽

pp. 578-581 ◽

Cited By ~ 20

Author(s):

Hannah G. Piper ◽

Nicole T. de Silva ◽

Joao G. Amaral ◽

Yaron Avitzur ◽

Paul W. Wales

Keyword(s):

Parenteral Nutrition ◽

Intestinal Failure ◽

Peripherally Inserted Central Catheters ◽

Central Catheters

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Comparison of complications associated with peripherally inserted central catheters and Hickman™ catheters in patients with intestinal failure receiving home parenteral nutrition. Six-year follow up study

Clinical Nutrition ◽

10.1016/j.clnu.2015.06.009 ◽

2016 ◽

Vol 35 (4) ◽

pp. 912-917 ◽

Cited By ~ 15

Author(s):

Line Dahlstrøm Christensen ◽

Mette Holst ◽

Laura Fuglsang Bech ◽

Lotte Drustrup ◽

Louis Nygaard ◽

...

Keyword(s):

Parenteral Nutrition ◽

Intestinal Failure ◽

Home Parenteral Nutrition ◽

Peripherally Inserted Central Catheters ◽

Follow Up Study ◽

Central Catheters

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Infectious Complications in Home Parenteral Nutrition: A Systematic Review and Meta-Analysis Comparing Peripherally-Inserted Central Catheters with Other Central Catheters

Nutrients ◽

10.3390/nu11092083 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2083

Author(s):

Raquel Mateo-Lobo ◽

Javier Riveiro ◽

Belén Vega-Piñero ◽

José I. Botella-Carretero

Keyword(s):

Relative Risk ◽

Parenteral Nutrition ◽

Blood Stream Infection ◽

Final Analysis ◽

Home Parenteral Nutrition ◽

Assessment Tools ◽

Peripherally Inserted Central Catheters ◽

Pubmed Database ◽

Central Catheters ◽

Crbsi Rate

Background: Home parenteral nutrition (HPN) has become a common therapy. There is still controversy regarding the possibility that peripherally inserted central catheters (PICCs) may diminish catheter-related blood stream infection (CRBSI) rates. Methods: We searched the PubMed database for studies reporting the rates of CRBSI with HPN. Study selection was performed independently by three investigators. Disagreements were discussed and resolved by consensus or by arbitration by an author not involved in the search. The National Institutes of Health Quality Assessment Tools was used to assess the methodological quality of the studies. Meta-analyses were performed using MetaXL 5.3 with the quality effects model. Results: Screening of the article titles and abstracts yielded 134 full text articles for evaluation. Only three prospective studies that included appropriate data were considered for the final analysis. The relative risk of the CRBSI rate was 0.41 (0.14–1.17) for PICC vs. tunneled catheters. The relative risk of the CRBSI rate was 0.16 (0.04–0.64) for PICC vs. ports. The relative risk of the thrombosis rate was 3.16 (0.20–49.67) for PICCs vs. tunneled. Conclusions: There is insufficient evidence to show a difference in CRBSI rates between PICCs and tunneled catheters. On the other hand, PICCs showed lower CRBSI rates than ports. There was also no difference in the rate of catheter-related thrombosis and mechanical complications.

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Role of Peripherally Inserted Central Catheters in Home Parenteral Nutrition

Journal of Parenteral and Enteral Nutrition ◽

10.1177/0148607112457422 ◽

2012 ◽

Vol 37 (4) ◽

pp. 544-549 ◽

Cited By ~ 23

Author(s):

Jose I. Botella-Carretero ◽

Carmen Carrero ◽

Eva Guerra ◽

Beatriz Valbuena ◽

Francisco Arrieta ◽

...

Keyword(s):

Parenteral Nutrition ◽

Home Parenteral Nutrition ◽

Peripherally Inserted Central Catheters ◽

Central Catheters

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Peripherally Inserted Central Catheter Experience in Long-Term Home Parenteral Nutrition Patients

Journal of the Association for Vascular Access ◽

10.1016/j.java.2016.12.001 ◽

2017 ◽

Vol 22 (1) ◽

pp. 42-45 ◽

Cited By ~ 2

Author(s):

Marianne Opilla

Keyword(s):

Parenteral Nutrition ◽

Complication Rate ◽

Venous Catheter ◽

Home Parenteral Nutrition ◽

Infusion Study ◽

Home Infusion ◽

Lock Therapy ◽

Antibiotic Lock ◽

Central Catheters

Abstract Parenteral nutrition is administered through a central venous catheter(CVC). Peripherally inserted central catheters (PICC) are appropriate for home parenteral nutrition (HPN). The objective of this study was to examine a group of HPN patients with a PICC in place for more than six months, and the complications associated with PICC removal. Medical records from one home infusion pharmacy were retrospectively reviewed for PICC characteristics and complications leading to removal. Nineteen adult HPN patients had 26 PICC placements. Total PICC days were 22,262 with a mean of 856 (265–2500) days. Seven PICCs were in place for 3 to greater than 5 years. The overall complication rate was 0.58/1000 CVC days. Catheter related bloodstream infection (CRBSI) was the main cause of PICC removal. There was no evidence of symptomatic thrombosis. Patients experienced no infusion related complications. The PICCs were 88% polyurethane, 65% double lumen, and 54% were 5 Fr. No patient received alcohol or antibiotic lock therapy, and 8 patients had successful alteplase administered at least one time. All patients needed caregiver assistance for site care and dressing changes, but were independent in HPN infusion and flushing. This group of patients demonstrated that PICCs are a viable option HPN administration. The PICC overall complication rate was very low, and the most frequent complication leading to removal was CRBSI. The infection rate of 0.36/1000 CVC days is considered very low in an HPN population. This is the only HPN infusion study to date reporting 7 PICCs lasting 3 or more years, with 2 lasting greater than 5 years without complications resulting in removal. Patients received their prescribed therapy reliably and without interruption with this device. Larger studies are needed to confirm the efficacy of maintaining a PICC for very long-term HPN administration.

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