Damage of Central Catheters in Home Parenteral Nutrition Patients

2015 ◽  
Vol 87 (11) ◽  
Author(s):  
Renata Błasiak ◽  
Michał Ławiński ◽  
Krystyna Majewska ◽  
Aleksandra Gradowska
Keyword(s):  
Parenteral Nutrition ◽  
Venous Catheter ◽  
Central Venous Line ◽  
Outpatient Setting ◽  
Central Catheter ◽  
Central Venous ◽  
Mechanical Complications ◽  
Catheter Complications ◽  
Aspen Guidelines ◽  
Central Catheters

AbstractAccording to the ESPEN and ASPEN guidelines, in the case of a long-term (>3-month) parenteral nutrition should be administered via a subcutaneous central venous catheter (CVC). There are three types of mechanical complications of tunnelled central catheter: catheter rupture, occlusion by TPN depositing and thrombofibrotic occlusion.was to analyse the incidence of complications central catheter in a group of patients receiving HPN.Between January 2010 and June 2014, HPN was conducted in 584 patients (306 women and 278 men), ninety-nine patients were enrolled in the study: 67 women and 32 men in whom mechanical complications of central catheters were found.Among 99 patients, 71 used the tunnelled Broviac catheter. Groshong catheters were placed only in patients receiving parenteral nutrition due to cancer. Analyses have shown differences between the older and younger in the number of mechanical complications. Younger patients were found to have a larger number of catheter complications (1.6 ± 1.1) in comparison with older patients (1.3 ± 0.7). The catheter that was most commonly damaged was the Broviac catheter 76.8%. The most frequent type of mechanical complications was catheter rupture 64.81%.Mechanical complications of tunnelled central catheters in HPN patients can be repaired in an outpatient setting in half of the cases, which enables continuation of parenteral nutrition without the need to hospitalise the patient. The centres that conduct HPN should offer 24-hour care and help in case of problems with the central venous line to the patients.

Complications of nutritional support

2013 ◽  
pp. 171-180
Author(s):  
Daniel Marks ◽  
Marcus Harbord
Keyword(s):  
Central Venous Catheter ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Right Atrium ◽  
Nutritional Support ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Central Catheters

Venous catheter-related problems Other complications of parenteral nutrition Problems with enteral tubes Re-feeding syndrome ● Above all else, ‘if the gut works, use it’. Only consider IV feeding if patients are likely to be without enteral nutrition for 〉5d. ● Central venous catheter feeding (i.e. catheter tip in SVC, IVC, or right atrium) preferred to avoid thrombophlebitis from hyperosmolar feeds. Well-managed central catheters can be left ...

scholarly journals Vias para Nutrição Artificial na Criança (II): Acessos Parentéricos

2014 ◽  
Vol 27 (6) ◽  
pp. 767
Author(s):  
José Estevão-Costa
Keyword(s):  
Parenteral Nutrition ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Venous Access ◽  
The Body ◽  
Central Catheter ◽  
Maintenance Care ◽  
Central Venous ◽  
Venous Catheterization

Parenteral nutrition is crucial when the use of the gastrointestinal tract is not feasible. This article addresses the main techniques for parenteral access in children, its indications, insertion details and maintenance, and complications. The type of venous access is mainly dictated by the expected duration of parenteral nutrition and by the body weight/stature. The peripheral access is viable and advantageous for parenteral nutrition of short duration (&lt; 2 weeks); a tunneled central venous catheter (Broviac) is usually necessary in long-term parenteral nutrition (&gt; 3 weeks); a peripherally introduced central catheter is an increasingly used alternative. Parenteral<br />accesses are effective and safe, but the morbidity and mortality is not negligible particularly in cases of short bowel syndrome. Most complications are related to the catheter placement and maintenance care, and can be largely avoided when the procedures are carried out by experienced staff under strict protocols.<br /><strong>Keywords:</strong> Child; Parenteral Nutrition; Catheterization, Central Venous; Catheterization, Peripheral.

scholarly journals Simultaneous Catheter Replacement for Infectious and Mechanical Complications without Interruption of Peritoneal Dialysis

2016 ◽  
Vol 36 (2) ◽  
pp. 182-187 ◽  
Author(s):  
John H. Crabtree ◽  
Rukhsana A. Siddiqi
Keyword(s):  
Peritoneal Dialysis ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous ◽  
Technique Survival ◽  
Mechanical Complications ◽  
Tunnel Infection ◽  
Catheter Complications ◽  
Systemic Antibiotics ◽  
Catheter Replacement

BackgroundConventional management for peritoneal dialysis (PD)-related infectious and mechanical complications that fails treatment includes catheter removal and hemodialysis (HD) via a central venous catheter with the end result that the majority of patients will not return to PD. Simultaneous catheter replacement (SCR) can retain patients on PD by avoiding the scenario of staged removal and reinsertion of catheters. The aim of this study was to evaluate a protocol for SCR without interruption of PD.MethodsClinical outcomes were analyzed for 55 consecutive SCRs performed from 2002 through 2012 and followed through 2013.ResultsSimultaneous catheter replacements were performed for 28 cases of relapsing peritonitis, 12 cases of tunnel infection, and 15 cases of mechanical catheter complications. All cases for peritonitis and tunnel infection and 80% for mechanical complications continued PD on the day of surgery using a low-volume, intermittent automated PD protocol. Systemic antibiotics were continued for 2 weeks postoperatively (up to 4 weeks for Pseudomonas). Simultaneous catheter replacement was performed as an outpatient procedure in 89.1% of cases. Only 1 of 55 procedures was complicated by peritonitis within 8 weeks. No catheter losses occurred during this postoperative timeframe. Long-term, SCR enabled a median technique survival of 5.1 years.ConclusionsIn most instances, SCR can be safely performed without interruption of PD for selected cases of peritonitis and tunnel infection and for mechanical catheter complications. The procedure spares the patient from a central venous catheter, a shift to HD, the psychological ordeal of a change in dialysis modality, and a second surgery to insert a new catheter.

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

2020 ◽  
Vol 21 (6) ◽  
pp. 861-867 ◽  
Author(s):  
Emanuele Iacobone ◽  
Daniele Elisei ◽  
Diego Gattari ◽  
Luigi Carbone ◽  
Giuseppe Capozzoli
Keyword(s):  
Central Venous Catheter ◽  
Transthoracic Echocardiography ◽  
Venous Catheter ◽  
Atrial Arrhythmia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Bubble Test ◽  
Central Catheters

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia. Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray. Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05). Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

scholarly journals Unexplained abdominal distention in a neonate: culprit femoral central venous line extravasation

2019 ◽  
Vol 12 (12) ◽  
pp. e232537
Author(s):  
Suresh Kotinatot ◽  
Shiva Shankar ◽  
Muhammad Eyad Ba'Ath ◽  
Munira Mahmoud Almaazmi
Keyword(s):  
Intensive Care ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Central Venous Line ◽  
Central Venous Catheters ◽  
Abdominal Distention ◽  
Rare Entity ◽  
Central Venous ◽  
Central Lines

Central venous lines are an essential part of neonatal intensive care and are used for infusion of medications and parenteral nutrition (PN). PN is usually given via either peripherally inserted central lines or umbilical venous lines. Occasionally, central venous catheters (CVCs) are inserted in the femoral veins. Extravasation of femoral venous catheter leading to ascites is a rare entity. This report describes the case of a neonate with a femoral CVC, who developed ascites as a result of extravasation of PN. Ascites resolved following the removal of the catheter.

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