Catheter-related complications in patients receiving home parenteral nutrition. 1980

C R Fleming, and D J Witzke, and R W Beart

Twenty-seven patients (22 adults, five adolescents, and one child) were treated with home parenteral nutrition (HPN) for 662 patient-months. A Broviac Silastic right atrial catheter which is tunnelled subcutaneously down the anterior chest wall served as a venous access. Thirty-four catheters were used in 27 patients, and the mean catheter life spans to date for adults and adolescents have been 21 and 14 months, respectively. There were no deaths attributable to the catheters. Infections and damaged external catheter segments were clustered in adult patients, whereas serious mechanical problems occurred in adolescents. Five of 27 patients (19%) experienced septicemia and one patient had two episodes. These six episodes (five of Staphylococcus aureus, one of Candida parapsilosis) in 662 patient-months represented only one case of sepsis every 9.1 patient-years on HPN. The external segments of 12 catheters were damaged and all were repaired in the outpatient setting. Eight of nine major mechanical problems occurred in five adolescents and one child; the most serious being four intravascular displacements, one extravascular displacement with mediastinitis, and a fractured catheter with a retained intravascular catheter segment. Although the HPN catheter is associated with definite risks, there has been a very acceptable incidence of complications resulting in a high benefit-to-risk ratio for HPN.

UI MeSH Term Description Entries
D008297 Male Males
D008480 Mediastinitis Inflammation of the mediastinum, the area between the pleural sacs. Mediastinum Inflammation,Inflammation, Mediastinum,Inflammations, Mediastinum,Mediastinitides,Mediastinum Inflammations
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D002177 Candidiasis Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed) Candida Infection,Moniliasis,Candida Infections,Candidiases,Infection, Candida,Moniliases
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D005767 Gastrointestinal Diseases Diseases in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Cholera Infantum,Gastrointestinal Disorders,Functional Gastrointestinal Disorders,Gastrointestinal Disorders, Functional,Disease, Gastrointestinal,Diseases, Gastrointestinal,Functional Gastrointestinal Disorder,Gastrointestinal Disease,Gastrointestinal Disorder,Gastrointestinal Disorder, Functional
D006701 Home Nursing Nursing care given to an individual in the home. The care may be provided by a family member or a friend. Home nursing as care by a non-professional is differentiated from HOME CARE SERVICES provided by professionals: visiting nurse, home health agencies, hospital, or other organized community group. Home Care, Non-Professional,Nursing, Home,Home Care, Nonprofessional,Care, Non-Professional Home,Care, Nonprofessional Home,Home Care, Non Professional,Non-Professional Home Care,Nonprofessional Home Care
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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