Central Line in Long-term Parenteral Nutrition in Children: A European Survey

Area of Science:

• Pediatric Gastroenterology
• Clinical Nutrition
• Vascular Access

Background:

• Current guidelines for central venous catheter (CVC) insertion and maintenance in pediatric long-term parenteral nutrition (PN) are over a decade old.
• Limited studies evaluate outcomes related to current CVC practices in children on home PN.
• There is a need to assess contemporary criteria for CVC management in this vulnerable population.

Purpose of the Study:

• To survey current criteria for CVC insertion and maintenance in European intestinal failure/rehabilitation centers.
• To identify variations in practice for children receiving home PN.
• To highlight the need for updated evidence-based recommendations.

Main Methods:

• An online cross-sectional survey was distributed to European experts in pediatric gastroenterology and home PN.
• The survey targeted members of relevant European professional networks and tertiary centers.
• Data collection focused on CVC insertion and maintenance protocols for pediatric home PN patients.

Main Results:

• Responses were received from 49 centers across 18 European countries and Israel.
• A high variability in CVC insertion and maintenance practices was observed among responding centers.
• Center size, defined by the number of home PN patients, varied, with a significant number managing 10-20 patients.

Conclusions:

• Significant heterogeneity exists in CVC insertion and maintenance practices for children on home PN across Europe.
• This variability may stem from outdated guidelines and a lack of robust evidence.
• Urgent collaborative research is required to develop standardized, evidence-based recommendations for optimal CVC care in pediatric home PN.