How to exchange a tunneled central venous catheter
Abstract:
Purpose: Patients with intestinal failure (IF) are dependent on tunneled central venous catheters (CVC) to provide parenteral nutrition. A method using a fibrous sheath (FS) was developed to preserve the central venous routes while exchanging CVC. We focused on the reduction of punctured catheter insertions for the FS method.
Methods: Patients with IF were divided into two groups. The n-FS group was comprised of patients who underwent primary insertion CVC only for the exchange CVC. The FS group was comprised of patients treated using the FS method. Patients diagnosed with CRBSI without septic shock received ethanol lock therapy. Outcomes included CVC durability days during the catheter insertion and primary punctured catheter insertion.
Results: Twenty patients with IF were treated. Seven patients were classified into the n-FS group and 13 patients were in FS group. Total number of CVC replacements of n-FS group and FS group were 27 and 43. Eighteen CVC replacements were used by FS method. The overall FS success rate was 100%. The CVC replacements per 1000 days was not significantly different between the two groups. The primary punctured catheter insertion was significantly lower in FS group compared with in n-FS group.
Conclusion: Our results suggest that the FS method reduces primary punctured catheter insertion.
Reference:
Hashizume N, Fujino A, Tomonaga K, Ozeki G, Saito T, Fujiogi M, Kano M, Yamamoto Y, Ishimaru T, Yoneda A, Kanamori Y. Fibrous Sheath Technique for Exchanging Tunneled Central Venous Catheters in Intestinal Failure Patients. Clin Nutr ESPEN. 2025 May 28:S2405-4577(25)00337-7. doi: 10.1016/j.clnesp.2025.05.040. Epub ahead of print. PMID: 40447221.