Maintenance of the central venous catheters in children on long-term parenteral nutrition

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CVC insertion and maintenance in children on home PN varies largely amongst centres in Europe. These differences could be at least partially explained by the lack of up-dated guidelines and limited evidence” Hojsak et al (2018).

Abstract:

BACKGROUND AND AIMS: The guidelines for the insertion and maintenance of the central venous catheter (CVC) in children on long-term parenteral nutrition (PN) were published 12 years ago and studies evaluating the outcomes are limited. Therefore, the aim of this study was to perform a survey about criteria for CVC insertion and maintenance in intestinal failure/rehabilitation centres treating children on home PN.

METHODS: An on-line cross-sectional survey based on previous European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) PN guidelines was distributed electronically to the members of the ESPGHAN networking group, Network for Intestinal Failure and Transplantation in Europe (NITE) and tertiary paediatric gastroenterology centres in Europe.

RESULTS: Overall, 55 responses from 49 centres in 18 European countries and Israel were collected. The majority of respondents were from the United Kingdom (10, 19%), followed by Germany (7, 13%) and France (6, 11%). Eleven centres (21%) cared for more than 30 patients, 8 (15%) centres between 20 to 30 patients, 18 (34%) centres between 10-20 patients and 16 (30%) less than 10 patients on home PN. There was a high variability in the majority of answers to the cross-sectional survey.

CONCLUSION: CVC insertion and maintenance in children on home PN varies largely amongst centres in Europe. These differences could be at least partially explained by the lack of up-dated guidelines and limited evidence. There is an urgent need for collaborative research to make recommendations about the best possible practice.



Reference:

Hojsak, I., Lacaille, F., Gupte, G.L. and Köglmeier, J. (2018) Central line in long term parenteral nutrition in children – a European survey. Journal of Pediatric Gastroenterology and Nutrition. June 18th. .

doi: 10.1097/MPG.0000000000002064.

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