Use of arteriovenous fistulae for home parenteral nutrition--a review of the literature. 2013

Azzam Al-Amin, and Jonathan Wood, and Gnanesh Atturu, and Mohammed R Gouda, and Clare F Donnellan, and Dermot A Burke
Department of Nutrition, Leeds Teaching Hospitals, Leeds, UK. azzam187@doctors.org.uk

OBJECTIVE Delivery of home parenteral nutrition (HPN), traditionally via tunneled central venous catheters (CVCs) is associated with several complications, the commonest being catheter related bloodstream infections. We have reviewed the literature to investigate the use of arteriovenous fistulae (AVF) as a viable alternative to traditional routes for long-term parenteral nutrition (PN). METHODS A literature search was performed using the Medline database, PubMed and a Google Scholar search. Search terms (keywords) used were: parenteral AND nutrition AND arteriovenous AND fistula for Title and Abstract. Our search yielded 12 articles (1972-2012). Two were excluded because of foreign language and difficult retrieval. The final yield was 10 papers RESULTS There were four case reports, six original papers (one Swedish, one French--both excluded), one abstract and one letter to the editor. There were 19 native AVF, 11 bovine grafts (BG), four synthetic grafts (SG) and 10 autologous venous grafts (AVG). The maximum recorded length of use was 86, 54, 16.7 and 300 months, respectively. Complication rates per fistula calculated from literature were 0.47, 1.18, 2.0 and 0.3 respectively. Apart from these results, a recent retrospective study (13) of 62 AVFs for HPN patients revealed an infection rate far lower than all types of CVC and a slightly higher occlusion rate than long-term CVCs. CONCLUSIONS There is relatively little data regarding this method. AVFs have been used successfully for HPN in patients with poor vasculature, on hemodialysis or recurrent line sepsis. This technique perhaps warrants more thorough exploration. Further research is required.

UI MeSH Term Description Entries
D001807 Blood Vessel Prosthesis Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels. Vascular Prosthesis,Blood Vessel Prostheses,Tissue-Engineered Vascular Graft,Graft, Tissue-Engineered Vascular,Grafts, Tissue-Engineered Vascular,Prostheses, Blood Vessel,Prostheses, Vascular,Prosthesis, Blood Vessel,Prosthesis, Vascular,Tissue Engineered Vascular Graft,Tissue-Engineered Vascular Grafts,Vascular Graft, Tissue-Engineered,Vascular Grafts, Tissue-Engineered,Vascular Prostheses,Vessel Prostheses, Blood,Vessel Prosthesis, Blood
D006083 Graft Occlusion, Vascular Obstruction of flow in biological or prosthetic vascular grafts. Graft Restenosis, Vascular,Vascular Graft Occlusion,Vascular Graft Restenosis,Graft Restenoses, Vascular,Occlusion, Vascular Graft,Restenosis, Vascular Graft
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001166 Arteriovenous Shunt, Surgical Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed) Shunt, Surgical Arteriovenous,Surgical Arteriovenous Shunt,Arteriovenous Shunts, Surgical,Shunts, Surgical Arteriovenous,Surgical Arteriovenous Shunts
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012648 Self Care Caring for self when ill or positive actions and adopting behaviors to prevent illness. Self-Care,Care, Self
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D016331 Parenteral Nutrition, Home The at-home administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered via a route other than the alimentary canal (e.g., intravenously, subcutaneously). Home Parenteral Nutrition,Nutrition, Home Parenteral,Parenteral Feeding, Home,Home Parenteral Feeding,Feeding, Home Parenteral
D016459 Prosthesis-Related Infections Infections resulting from the implantation of prosthetic devices. The infections may be acquired from intraoperative contamination (early) or hematogenously acquired from other sites (late). Prosthesis Related Infection,Prosthesis-Related Infection,Infections, Prosthesis-Related,Infection, Prosthesis Related,Prosthesis Related Infections,Related Infection, Prosthesis,Related Infections, Prosthesis
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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