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Garcés-Carrasco AM, Santacatalina-Roig E, Carretero-Márquez C, Martínez-Sabater A, Balaguer-López E. Complications Associated with Peripherally Inserted Central Catheters (PICC) in People Undergoing Autologous Hematopoietic Stem Cell Transplantation (HSCT) in Home Hospitalization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1704. [PMID: 36767070 PMCID: PMC9914549 DOI: 10.3390/ijerph20031704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The SARS-CoV-2 pandemic generated the need to keep immunosuppressed patients away from hospital institutions for as long as possible. This in turn stimulated the implementation of a home hospitalization model for autologous hematopoietic stem-cell transplantation (HSCT). PURPOSE To analyze whether there are significant differences in post-transplantation complications related to catheters observed in patients treated in the home-transplant care modality compared to patients treated in the hospital. METHODOLOGY Observational, analytical, longitudinal, and retrospective study of cases and controls. A convenience sample was chosen, in which the cases comprised 20 patients included in the home HSCT care model. For each patient, it was considered suitable to propose two controls among those who received autologous transplantation in the last five years with a baseline demographic and pathological profile similar to the case for whom they were control. RESULTS The home patients achieved an average of 22.4 ± 2.6 days of evolution with an average of 16.4 ± 2.08 days post-transplant, compared to the hospital process with an average of 21.21 ± 4.18 days of evolution and 15.51 ± 3.96 days post-transplant (evolution days p = 0.022; post-transplant days p = 0.002). A higher percentage of use of parenteral nutrition (p = 0.036) and transfusions (p = 0.003) was observed during the post-transplant phase in the hospital. The rest of the therapeutic measures did not show significant differences. When analyzing the frequency of adverse effects in the post-transplant phase, a significant increase in neutropenic fever (OR = 8.55) and positive blood cultures (OR = 6.65) was observed in hospital patients. Any other significant differences in other variables related to PICC were found (presence and days of neutropenic fever, catheter infection, complications, pathogens, admission to the ICU, or death). Concerning local complications (pain, DVT, Medical adhesive-related Skin Injury, and erythema), there was more erythema in the hospital (p = 0.056). CONCLUSIONS The results obtained indicate that regarding the appearance of complications associated with PICCs in home hospitalization HSCT patients, there are no significant differences compared to hospitalization, so that home care can be a safe context for people with these lines.
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Affiliation(s)
- Ana María Garcés-Carrasco
- Oncology and Hematology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Enric Santacatalina-Roig
- Oncology and Hematology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Carlos Carretero-Márquez
- Oncology and Hematology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Antonio Martínez-Sabater
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 Valencia, Spain
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain
- Grupo Asociado de Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Evelin Balaguer-López
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 Valencia, Spain
- Grupo Asociado de Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
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Patient characteristics and clinical outcomes in a specialised intestinal failure unit: An observational cohort study. Clin Nutr ESPEN 2020; 38:253-262. [DOI: 10.1016/j.clnesp.2020.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 12/20/2022]
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Marsh N, Larsen E, Tapp S, Sommerville M, Mihala G, Rickard CM. Management of Hospital In The Home (HITH) Peripherally Inserted Central Catheters: A Retrospective Cohort Study. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822319873334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Worldwide, there has been a shift in health care delivery, with an increasing emphasis on avoiding hospital admissions and providing treatment such as intravenous antibiotics for patients at home, using peripherally inserted central catheters (PICCs). However, there is inadequate data to demonstrate if rates of PICC failure are similar for hospital inpatients, currently understood to be between 7% and 36%, than those cared for at home. The objective of this study was to identify prevalence, dwell time, and complications associated with PICCs in the home setting. This single-center, retrospective cohort study of adults treated by the “Hospital in the Home” (HITH) program in Queensland, was conducted between June 1, 2017 and June 15, 2018. Clinical data were collected for patient and PICC characteristics. Variables were described as frequencies and proportions, means and standard deviations, or medians and interquartile ranges. In total, 304 patients treated by HITH during this timeframe, and 164 (54%) patients with 181 PICCs were included in this study. These patients were predominately male (n = 105, 64%), with a mean age of 54 years. The most common reason for admission was a wound infection and/or bone infection (n = 120, 33%). Most PICCs were single lumen (n = 120; 67%), inserted in the basilic vein (n = 137; 80%) by nurses (n = 122; 67%). Peripherally inserted central catheter failure occurred in 10% (n = 19); the most common complications were dislodgement (n = 9; 5%) and thrombosis (n = 4; 2%). There were no confirmed catheter-related blood stream infections. Peripherally inserted central catheter failure rates are similar between hospitalized inpatients and those cared for at home.
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Affiliation(s)
- Nicole Marsh
- Royal Brisbane and Women’s Hospital, Queensland, Australia
- Griffith University, Brisbane, Queensland, Australia
| | - Emily Larsen
- Royal Brisbane and Women’s Hospital, Queensland, Australia
- Griffith University, Brisbane, Queensland, Australia
| | - Sam Tapp
- Royal Brisbane and Women’s Hospital, Queensland, Australia
| | | | - Gabor Mihala
- Griffith University, Brisbane, Queensland, Australia
| | - Claire M. Rickard
- Royal Brisbane and Women’s Hospital, Queensland, Australia
- Griffith University, Brisbane, Queensland, Australia
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Reitzel RA, Rosenblatt J, Chaftari AM, Raad II. Epidemiology of Infectious and Noninfectious Catheter Complications in Patients Receiving Home Parenteral Nutrition: A Systematic Review and Meta-Analysis. JPEN J Parenter Enteral Nutr 2019; 43:832-851. [PMID: 31172542 DOI: 10.1002/jpen.1609] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/03/2019] [Indexed: 12/14/2022]
Abstract
Patients receiving parenteral nutrition (PN) as their primary source of nutrition are at high risk for both infectious and noninfectious catheter complications (catheter-related infections, catheter occlusion, and venous thrombosis). The aim of this review was to synthesize and evaluate what is known about catheter complications and prevention strategies in the PN population. Three electronic databases (Medline, Embase, and CINAHL) were screened for studies published between January 2012 and February 2019 regarding infectious and noninfectious catheter complications in patients receiving PN. Rates of infectious and noninfectious catheter complications, prevalence of causative pathogens, potential risk factors, and prevention strategies via the use of antimicrobial lock therapy (ALT) were assessed. Fifty-three catheter complication studies and 12 ALT studies were included. Studies were grouped by definition of complication: catheter-related bloodstream infections (CRBSI) or central line-associated bloodstream infections (CLABSI). Random effects summary rates per 1000 catheter days were 0.85 CRBSI episodes (95% CI 0.27-2.64) and 1.65 CLABSI episodes (95% CI 1.09-2.48). Use of taurolidine or ethanol ALT was efficacious in reducing infectious catheter complications; however, several studies had concerns for adverse mechanical complications. Potential risk factors for catheter complications were highly varied and often contradictory between studies. The rates of catheter complications were higher among catheterized patients receiving PN compared with nationally reported rates of complications in all catheterized patients. Risk factors for catheter complications need to be better understood for targeted prophylactic use of ALT. Future studies are warranted; however, they should be conducted using more standardized definitions and criteria.
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Affiliation(s)
- Ruth A Reitzel
- Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Campagna S, Gonella S, Berchialla P, Rigo C, Morano G, Zerla PA, Fuzzi R, Corona G, Storto S, Dimonte V, Mussa B. A retrospective study of the safety of over 100,000 peripherally-inserted central catheters days for parenteral supportive treatments. Res Nurs Health 2019; 42:198-204. [PMID: 30912181 DOI: 10.1002/nur.21939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/16/2019] [Accepted: 02/17/2019] [Indexed: 01/08/2023]
Abstract
The type of central vascular access device providers chosen for providing parenteral supportive treatments has evolved over the past years, going from routinely used centrally inserted catheters to a more recent trend of peripherally-inserted central catheters (PICCs) when expected treatment duration is less than 6 months. This multicenter retrospective study aimed to provide a comprehensive assessment of the safety of PICCs in administering parenteral supportive treatments. All adult inpatients and outpatients who had a PICC inserted for the administration of parenteral supportive treatments (i.e., parenteral nutrition, intravenous fluids, blood products, or antibiotics) between September 2007 and December 2014 in four public Italian hospitals were included. The primary outcome was PICC removal because of an adverse event (AE, defined as occlusion, exit-site infection, or symptomatic thrombosis). Among the 1,250 included patients, 178 PICC-related removals because of AEs (14.2%; 1.62 AEs per 1,000 PICC days) were reported. Rates of PICC removal because of occlusion, exit-site infection, and symptomatic thrombosis were 1.08, 0.32, and 0.23 per 1,000 PICC days, respectively. The median dwell-time between PICC insertion and its removal because of an AE was 67 days (interquartile range 28-180 days). Risk of PICC removal due to AE was higher with open-system PICCs [hazard ratio = 2.75, 95% confidence interval 1.52-4.96]. In this study, we found preliminary evidence that PICCs can be safely used to administer parenteral supportive treatments lasting up to 6 months. PICCs may be a relevant alternative to centrally inserted catheters for medium-term parenteral supportive treatments.
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Affiliation(s)
- Sara Campagna
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Silvia Gonella
- Management Division of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Carla Rigo
- Oncology Department, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giacomo Morano
- Ematology Department, Azienda Policlinico Umberto I, Roma, Italy
| | - Pietro Antonio Zerla
- Vascular Access Team, Azienda Socio Sanitaria Territoriale Melegnano e della Martesana, Milan, Italy
| | - Raffaella Fuzzi
- Breast Unit, Azienda Unità Sanitaria Locale?, Romagna sede di Forlì, Forlì, Italy
| | - Gianvito Corona
- Territorial Oncology and Palliative Care, Azienda Sanitaria Provinciale Potenza, Potenza, Italy
| | - Silvana Storto
- Management Division of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy.,Oncology Department, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy
| | - Valerio Dimonte
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.,Management Division of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy
| | - Baudolino Mussa
- Management Division of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy.,Department of Surgical Sciences, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, Turin, Italy
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Ozcelik H, Gozum S, Ozer Z. Is home parenteral nutrition safe for cancer patients? Positive effects and potential catheter-related complications: A systematic review. Eur J Cancer Care (Engl) 2019; 28:e13003. [PMID: 30739373 DOI: 10.1111/ecc.13003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/30/2018] [Accepted: 01/08/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Total Parenteral Nutrition began to be applied frequently in the houses of patients starting from the 1990s and is stated in literature as Home Parenteral Nutrition (HPN). The purpose of this review is to answer the question of whether or not HPN is safe for cancer patients. METHODS Searches were conducted in Cochrane, CINAHL, PubMed, Springer, Google Scholar, and the Web of Science databases. RESULTS The 1,949 articles were accessed in the total, and 20 articles have been included in the review. In the studies being evaluated, it can be determined that HPN has influenced the quality of life, performance status, and the nutrition level of cancer patients positively. Most frequently seen complications were infections relating to the catheter, the mechanical obstruction in the catheter and venous thrombosis. For each 1,000 days with HPN or a catheter, infections in the interval of 0.05 and 3.08, mechanical problems in the interval of 0.07 and 2.13, and thrombosis in the interval of 0.05 and 0.20 were determined. CONCLUSIONS While HPN influenced quality of life, nutrition, and the personal performance of cancer patients positively, the rate of complications is at a level that can be managed at home.
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Affiliation(s)
- Habibe Ozcelik
- Oncology Clinic, Akdeniz University Hospital, Antalya, Turkey.,Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Sebahat Gozum
- Department of Public Health Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Zeynep Ozer
- Department of Internal Diseases Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Vashi PG, Virginkar N, Popiel B, Edwin P, Gupta D. Incidence of and factors associated with catheter-related bloodstream infection in patients with advanced solid tumors on home parenteral nutrition managed using a standardized catheter care protocol. BMC Infect Dis 2017; 17:372. [PMID: 28558699 PMCID: PMC5450397 DOI: 10.1186/s12879-017-2469-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/16/2017] [Indexed: 12/17/2022] Open
Abstract
Background Catheter-related bloodstream infections (CRBSIs) are associated with high morbidity and mortality as well as increased medical costs. Cancer patients, who are often immunocompromised, are susceptible to CRBSI while receiving home parenteral nutrition (HPN). We evaluated the incidence of and factors associated with CRBSIs in cancer patients undergoing HPN managed using a standardized catheter care protocol. Methods This is a retrospective cohort study of 335 cancer patients receiving HPN between January 2012 and July 2015. The primary outcome of interest was the incidence of CRBSI expressed as events per 1000 HPN days. HPN days were calculated from the start date with the home infusion provider until the discontinuation of HPN, or the removal of the venous access device (VAD), or the death of the patient. The VADs used were either peripherally inserted central catheters (PICCs) or a subcutaneous implanted port or tunneled central catheters (TCCs). Univariate Poisson regression analyses were used to determine the variables associated with CRBSIs. Results Of 335 patients, 193 were females and 142 were males. The most common cancer types were colorectal, pancreatic, ovarian and stomach. A total of 408 VADs in 335 patients were studied, covering a total of 29,403 HPN days. Of 408 VADs, 206 (50.5%) were ports, 191 (46.8%) were PICCs, and 7 (2.7%) were TCCs. The median duration of HPN was 54 days. A total of 16 CRBSI episodes were recorded (8 in ports, 7 in PICCs and 1 in TCCs). The median duration from the start of HPN to the development of CRBSI episodes was 43.5 days. The overall incidence of CRBSI per 1000 HPN days was 0.54 (95% confidence interval: 0.32–0.86). Upon univariate analysis, no variables were found to be statistically significantly associated with CRBSI incidence. Conclusions We found a low rate of CRBSI following a standardized catheter maintenance protocol in a high-risk oncology population undergoing HPN.
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Affiliation(s)
- Pankaj G Vashi
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, Illinois, 60099, USA
| | - Natasha Virginkar
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, Illinois, 60099, USA
| | - Brenten Popiel
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, Illinois, 60099, USA
| | - Persis Edwin
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, Illinois, 60099, USA
| | - Digant Gupta
- Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Ave, Zion, Illinois, 60099, USA.
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Rajan S, Paul J, Kumar L. Spontaneous repositioning of a malpositioned peripherally inserted central catheter. Indian J Anaesth 2016; 60:148-9. [PMID: 27013762 PMCID: PMC4787134 DOI: 10.4103/0019-5049.176283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Sunil Rajan
- Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Jerry Paul
- Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Lakshmi Kumar
- Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Hortencio TDR, Arendt BM, Teterina A, Jeejeebhoy KN, Gramlich LM, Whittaker JS, Armstrong D, Raman M, Nogueira RJN, Allard JP. Changes in Home Parenteral Nutrition Practice Based on the Canadian Home Parenteral Nutrition Patient Registry. JPEN J Parenter Enteral Nutr 2015; 41:830-836. [DOI: 10.1177/0148607115609289] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Taís Daiene Russo Hortencio
- State University of Campinas, Unicamp, São Paulo, Brazil
- Toronto General Hospital, University Health Network, Toronto, Canada
| | | | | | | | | | - J. Scott Whittaker
- Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, Canada
| | - David Armstrong
- Hamilton Health Sciences and McMaster University, Hamilton, Canada
| | | | | | - Johane P. Allard
- Toronto General Hospital, University Health Network, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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Christensen LD, Rasmussen HH, Vinter-Jensen L. Regarding the Response to "Peripherally Inserted Central Catheter for Use in Home Parenteral Nutrition: A 4-Year Follow-up Study". JPEN J Parenter Enteral Nutr 2015; 39:761-2. [PMID: 26287015 DOI: 10.1177/0148607115569735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Paauw JD, Davis AT. Response to "Peripherally Inserted Central Catheter for Use in Home Parenteral Nutrition: A 4-Year Follow-Up Study". JPEN J Parenter Enteral Nutr 2015; 39:761. [PMID: 26287014 DOI: 10.1177/0148607115569734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Christensen LD, Holst M, Bech LF, Drustrup L, Nygaard L, Skallerup A, Rasmussen HH, Vinter-Jensen L. 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. Clin Nutr 2015; 35:912-7. [PMID: 26269383 DOI: 10.1016/j.clnu.2015.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 05/14/2015] [Accepted: 06/26/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIM Patients with intestinal failure (IF) are dependent on parenteral nutrition delivered through central access such as Hickman™ catheters. The peripherally inserted central catheter (PICC) is becoming increasingly popular for the purpose. The aim of the present study was to compare complication rates between the two types of catheters. PATIENTS AND METHODS Over a six-year period (2008-2014), we included 136 patients with IF receiving home parenteral nutrition (HPN). These patients had a total of 295 catheters (169 Hickman™ catheters and 126 PICCs). Data were collected by reviewing their medical records. Incidences are given per 1000 catheter days. Data are given as means ± standard deviation (SD) and compared using independent student's t-tests, Mann-Whitney-Wilcoxon, and X(2)-tests. A survival analysis for time to the first infection was conducted using Cox regression. RESULTS The total number of catheter days was 54,912 days for Hickman™ catheters (mean dwell time 325 ± 402) and 15,974 days for PICCs (mean dwell time 127 ± 121), respectively. The incidence of catheter-related blood stream infection (CRBSI) per 1000 catheter days was significantly lower for Hickman™ catheters compared to PICCs (0.56 vs. 1.63, p < 0.05). The mean time to first CRBSI was significantly shorter for PICCs compared to Hickman™ catheters (84 ± 94 days vs. 297 ± 387 days, p < 0.05), which was confirmed with a cox analysis corrected for age and gender. A total of 75 catheters were removed due to CRBSI, 49 Hickman™ catheters and 26 PICCs respectively. In addition, PICCs were more often removed due to local infection/phlebitis and mechanical causes (p < 0.001). CONCLUSION We found a higher risk and shorter time to first CRBSI in PICCs compared to Hickman catheters supporting that PICCs should mainly be chosen for planned HPN up to 3-6 months. We therefore conclude that the choice of catheter must still be determined on an individual basis.
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Affiliation(s)
- Line Dahlstrøm Christensen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
| | - Mette Holst
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Lotte Drustrup
- School of Medicine and Health, Aalborg University, Aalborg, Denmark
| | - Louis Nygaard
- School of Medicine and Health, Aalborg University, Aalborg, Denmark
| | - Anders Skallerup
- School of Medicine and Health, Aalborg University, Aalborg, Denmark
| | - Henrik Højgaard Rasmussen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Vinter-Jensen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
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Sangster A. Home parenteral nutrition: a multi-professional approach. Br J Community Nurs 2015; Suppl Nutrition:S24, S26-7. [PMID: 26087204 DOI: 10.12968/bjcn.2015.20.sup6a.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article explores the complexities of home parenteral nutrition (HPN) and how it has developed as a home therapy. It examines the various indications and treatment options, discussing access and the associated complications. The relationship between the multiprofessional team is paramount to the success of the therapy. Working in partnership with home-care providers is also discussed. It gives an overview of patients receiving parenteral nutrition at home and the impact it has on their lives.
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Bech LF, Drustrup L, Nygaard L, Skallerup A, Christensen LD, Vinter-Jensen L, Rasmussen HH, Holst M. Environmental Risk Factors for Developing Catheter-Related Bloodstream Infection in Home Parenteral Nutrition Patients. JPEN J Parenter Enteral Nutr 2015; 40:989-94. [DOI: 10.1177/0148607115579939] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/03/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Fuglsang Bech
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Lotte Drustrup
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Louis Nygaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Anders Skallerup
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Line Dahlstrøm Christensen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Vinter-Jensen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Højgaard Rasmussen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Holst
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
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