Central venous access device complications with parenteral nutrition

The results showed that patients receiving PN through CVADs within general ward settings experience CRBSI at rates no different from those reported within critical care settings” Martincich et al (2019).

Abstract:

BACKGROUND: Central venous access devices (CVADs) are used widely in acute clinical settings for the infusion of parenteral nutrition (PN) in patients who are unable to meet their nutrition requirements via the oral or enteral routes. The aim of this study was to characterize the frequency and nature of CVAD complications in patients receiving PN in general ward settings.

METHODS: A retrospective analysis of CVAD-related outcomes for adult patients who received PN from January 2014 to December 2016 was conducted.

RESULTS: A total of 629 CVADs were placed in 475 patients for parenteral administration in general ward settings during the 3-year study period. A total 104 (16.53%) episodes of CVAD-associated complications were reported during this period, including suspected line infection, leak at site, catheter blockage, and generalized patient sepsis. Overall, 13 CVAD catheter-related bloodstream infections (CRBSIs) were diagnosed in the patient cohort over 8695 PN feeding days, giving an incidence of 1.49 CVAD infections per 1000 PN feeding days.

CONCLUSION: The results showed that patients receiving PN through CVADs within general ward settings experience CRBSI at rates no different from those reported within critical care settings. These findings demonstrate that with appropriate nursing care, CVADs appear safe when used for the administration of PN in general ward settings.

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Reference:

Martincich, I., Cini, K., Lapkin, S., Lord, H. and Fernandez, R. (2019) Central Venous Access Device Complications in Patients Receiving Parenteral Nutrition in General Ward Settings: A Retrospective Analysis. JPEN. November 29th. doi: 10.1002/jpen.1743. .

Safety IV catheter