Optimizing Intravenous Access for Long-Term Parenteral Nutrition.

Autor: Hurt RT; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. hurt.ryan@mayo.edu.; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA. hurt.ryan@mayo.edu.; Program Director, Home Parenteral Nutrition Program, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. hurt.ryan@mayo.edu., Mohamed Elfadil O; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA., Edakkanambeth Varayil J; Department of Family Medicine, Mayo Clinic, Rochester, MN, USA., Bonnes SL; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA., Salonen BR; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA., Mundi MS; Division of Endocrinology, Mayo Clinic, Rochester, MN, USA.
Jazyk: angličtina
Zdroj: Current nutrition reports [Curr Nutr Rep] 2024 Jun; Vol. 13 (2), pp. 323-330. Date of Electronic Publication: 2024 May 02.
DOI: 10.1007/s13668-024-00534-y
Abstrakt: Purpose of Review: Securing safe and effective intravenous (IV) access is of utmost importance for administering parenteral nutrition (PN). Sustaining this access can indeed pose challenges, especially when dealing with the risk of complications associated with long-term PN. This review emphasizes best practices to optimize intravenous access and reviews the current evidence-based recommendations and consensus guidelines.
Recent Findings: An individualized approach when selecting central venous catheters (CVC) is recommended, considering the estimated duration of need for IV access and the number of lumens needed. Established and novel approaches to minimize complications, including infection and thrombosis, are recognized. These include placement and positioning of the catheter tip under sonographic guidance and the use of antimicrobial lock therapies. Moreover, when possible, salvaging CVCs can reduce the risk of vascular access loss. CVC selection for patients requiring PN depends on several factors. Carefully reviewing an individual patient's clinical characteristics and discussing options is important. Given the increased infection risk, CVC lumens should be minimized. For long-term PN beyond 6 months, using CVCs with skin barriers and larger diameters should be considered.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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