Abstract
Purpose
To determine the incidence of central venous catheter (CVC) complications and to analyze the potential risk factors for complications necessitating CVC removal in patients on home parenteral nutrition (HPN).
Methods
We studied 68 patients on HPN (44 men and 24 women), examining the incidence of CVC complications and CVC-related infections. The risk factors for CVC-related infection were investigated using multivariate logistic regression analysis.
Results
the incidences of CVC complications were 0.29 episodes per CVC-year in 45 patients with an external tunneled CVC, and 0.66 episodes per CVC-year in 23 patients with an implanted port device. The incidences of CVC-related infections were 0.17 episodes per CVC-year for external tunneled CVCs and 0.17 episodes per CVC-year for implanted port devices. There were no significant differences in the incidences of CVC complications (P = 0.095), and CVC-related infections (P = 0.406). The incidences of CVC-related infections were 0.04 episodes per CVC-year in 54 patients with malignancies, and 0.68 episodes in 14 patients with benign diseases (P < 0.001). Multivariate logistic regression analysis revealed the types of diseases that influenced the incidence of CVC-related infections (P < 0.05).
Conclusions
The incidence of CVC complications did not differ between the two groups. The type of disease was the most important predictive factor of CVC-related infections.
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References
MA Stokes M Irving (1989) ArticleTitleMortality in patients on home parenteral nutrition J Parenter Enteral Nutr 13 172–5 Occurrence Handle1:STN:280:BiaB3Mjis1U%3D
JW Broviac JJ Cole BH Scribner (1973) ArticleTitleA silicone rubber atrial catheter for prolonged parenteral alimentation Surg Gynecol Obstet 136 602–6 Occurrence Handle1:STN:280:CSyC3s3psFM%3D Occurrence Handle4632149
RO Hickman CD Buckner RA Clift JE Sanders P Stewart ED Thomas (1979) ArticleTitleA modified right atrial catheter for access to the venous system in marrow transplant recipients Surg Gynecol Obstet 148 871–5 Occurrence Handle1:STN:280:CSaB3czlvFM%3D Occurrence Handle109934
B Messing F Man R Colimon F Thuillier M Beliah (1990) ArticleTitleAntibiotic-lock technique is an effective treatment of bacterial catheter–related sepsis during parenteral nutrition Clin Nutr 9 220–5
BM Dobbins P Kite MH Wilcox (1999) ArticleTitleDiagnosis of central venous catheter-related sepsis, a critical look inside J Clin Pathol 52 165–72 Occurrence Handle1:STN:280:DyaK1MznvVKltQ%3D%3D Occurrence Handle10450173
T Takagi A Okada T Sato T Fukushima N Shirotani Y Osawa et al. (1995) ArticleTitleReport on the first annual survey of home parenteral nutrition in Japan Surg Today 25 193–201 Occurrence Handle1:STN:280:ByqA28jnsFM%3D Occurrence Handle7640446
Bozzetti F, Mariani L, Boggio BD, Chiavenna G, Crose M, Cicco DE, et al. Central venous catheter complications in 447 patients on home parenteral nutrition: an analysis of over 100 000 catheter days. Clin Nutr 2002;475–85
O Khvatyuk N Simon M Birch M Schattner M Klang R Barrera et al. (2001) ArticleTitleInfectious complications in home parenteral nutrition patients: 30 years of experience at a comprehensive cancer center Clin Nutr 20 IssueIDSuppl 3 72
L Howard C Ashley (2003) ArticleTitleManagement of complications in patients receiving home parenteral nutrition Gastroenterology 124 1651–61 Occurrence Handle10.1016/S0016-5085(03)00326-3 Occurrence Handle12761723
DG Kelly JU Burnes R Thompson (2001) ArticleTitleHPN CVC infections: 1 000 patient years (PY) experience Clin Nutr 20 IssueIDSuppl 3 34
CR Pennington (1995) ArticleTitleCentral vein thrombosis during home parenteral nutrition Clin Nutr 14 IssueIDSuppl 1 52–5
L Howard N Hassan (1998) ArticleTitleHome parenteral nutrition. 25 years later Gastroenterol Clin North Am 27 481–512 Occurrence Handle10.1016/S0889-8553(05)70015-7 Occurrence Handle1:STN:280:DyaK1czhtlOitw%3D%3D Occurrence Handle9650029
L Santarpia F Pasanisi L Alfonsi G Violante D Tsseo G Simone et al. (2002) ArticleTitlePrevention and treatment of implanted central venous catheter (CVC)-related sepsis: a report after six years of home parenteral nutrition (HPN) Clin Nutr 21 207–211 Occurrence Handle12127928
JM Reimund Y Arondel G Finck F Zimmermann B Duclos R Baumann (2002) ArticleTitleCatheter-related infection in patients on home parenteral nutrition: results of a prospective survey Clin Nutr 21 33–8 Occurrence Handle10.1054/clnu.2001.0500 Occurrence Handle11884010
E Steiger (2002) ArticleTitleObtaining and maintaining vascular access in the home parenteral nutrition patient J Parenter Enteral Nutr 26 17–20
MN Terra C Plopper DL Waitzberg C Cukier S Santoro JR Martins et al. (2000) ArticleTitleRemaining small bowel length: association with catheter sepsis in patients receiving home parenteral nutrition: evidence of bacterial translocation World J Surg 24 1537–41 Occurrence Handle10.1007/s002680010274 Occurrence Handle1:STN:280:DC%2BD3M3gtFKguw%3D%3D Occurrence Handle11193720
E Hamaoui (1987) ArticleTitleAssessing the nutrition support team J Parenter Enteral Nutr 11 412–21 Occurrence Handle1:STN:280:BiiB1cvjtVE%3D
M Regenstein (1992) ArticleTitleNutritional support team — alive, well, and still growing. Results of a 1991 A.S.P.E.N. survey Nutr Clin Pract 7 298–301
WC Faubion JR Wesley N Khalidi J Silva (1986) ArticleTitleTotal parenteral nutrition catheter sepsis: impact of the team approach J Parenter Enteral Nutr 10 642–5 Occurrence Handle1:STN:280:BiiD1cjgslw%3D
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Shirotani, N., Iino, T., Numata, K. et al. Complications of Central Venous Catheters in Patients on Home Parenteral Nutrition: An Analysis of 68 Patients over 16 Years. Surg Today 36, 420–424 (2006). https://doi.org/10.1007/s00595-005-3179-0
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DOI: https://doi.org/10.1007/s00595-005-3179-0