Management of Central Venous Catheters in Children and Adults on Home Parenteral Nutrition: A French Survey of Current Practice

Nutrients. 2022 Jun 18;14(12):2532. doi: 10.3390/nu14122532.

Abstract

Although central venous catheter (CVC)-related thrombosis (CRT) is a severe complication of home parenteral nutrition (HPN), the amount and quality of data in the diagnosis and management of CRT remain low. We aimed to describe current practices regarding CVC management in French adult and pediatric HPN centers, with a focus on CVC obstruction and CRT. Current practices regarding CVC management in patients on HPN were collected by an online-based cross-sectional survey sent to expert physicians of French HPN centers. We compared these practices to published guidelines and searched for differences between pediatric and adult HPN centers' practices. Finally, we examined the heterogeneity of practices in both pediatric and adult HPN centers. The survey was completed by 34 centers, including 21 pediatric and 13 adult centers. We found a considerable heterogeneity, especially in the responses of pediatric centers. On some points, the centers' responses differed from the current guidelines. We also found significant differences between practices in adult and pediatric centers. We conclude that the management of CVC and CRT in patients on HPN is a serious and complex situation for which there is significant heterogeneity between HPN centers. These findings highlight the need for more well-designed clinical trials in this field.

Keywords: catheter obstruction; central venous catheter thrombosis; chronic intestinal failure; venous thrombosis.

MeSH terms

  • Adult
  • Catheterization, Central Venous* / adverse effects
  • Central Venous Catheters* / adverse effects
  • Child
  • Cross-Sectional Studies
  • Humans
  • Parenteral Nutrition, Home* / adverse effects
  • Retrospective Studies

Grants and funding

This research received no external funding.