Related Experiment Video
Updated: Nov 12, 2025
Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Impact of central venous catheter repair in pediatric intestinal failure
Velarchana Santhana1, Mary Beth Davis2, Riad Rahhal3
1Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Insights
Catheter repair effectively extends the life of central venous catheters (CVCs) in pediatric patients with intestinal failure (IF) without raising infection risks. This approach offers a viable alternative to replacement for damaged CVCs.
Area of Science:
- Medical Sciences
- Pediatric Gastroenterology
- Vascular Access Devices
Background:
- Patients with intestinal failure (IF) rely on central venous catheters (CVCs) for long-term parenteral nutrition.
- Damage to CVCs necessitates consideration of repair or replacement, yet repair outcomes in this population are sparsely documented.
Purpose of the Study:
- To evaluate the impact of CVC repair on catheter durability and infection rates in pediatric patients with IF.
- To assess the effectiveness and safety of CVC repair as an alternative to replacement.
Main Methods:
- A retrospective cohort study analyzed data from pediatric IF patients with tunneled silicone CVCs over a 10-year period.
- Outcomes assessed included CVC longevity, repair success rates, need for replacement, and post-repair infection rates.
Main Results:
- CVC repair significantly increased median durability from 123 to 391 days (P < .0001).
- The overall repair success rate was 96%, though lower (81%) in emergency settings.
- Post-repair infection rates remained low at 2.2% within 7 days, with no specific risk factors identified.
Conclusions:
- CVC repair is an effective strategy for prolonging catheter survival in pediatric IF patients.
- Repair does not appear to increase infection rates, making it a safe alternative to replacement.
- Consideration of temporary repairs before permanent ones may help manage intraluminal thrombosis.
Objectives:
Patients with intestinal failure (IF) require long-term parenteral nutrition through central venous catheters (CVCs). When damaged, catheter replacement or repair is considered. Limited literature exists on repair outcomes in this population. We aimed to assess the impact of repair on durability of exiting CVCs and infection rates.
Methods:
This was a retrospective cohort study of pediatric IF patients with tunneled silicone CVCs over 10 years. Outcomes were evaluated by assessing CVC longevity, repair success, replacement, and postrepair infection rates.
Results:
One hundred thirty-eight repairs and 45 replacements were conducted in 37 patients with repair and replacement rates of 4.7 and 1.5 per 1000 catheter days, respectively. Twenty patients (54%) required ≥1 repair. For CVCs requiring repair, median CVC durability without and with repairs were at 123 and 391 days, respectively (P < .0001). Overall repair success rate was 96% with significantly lower success in the emergency department at 81% (P = .007). The 7-day postrepair infection rate was 2.2% without specific risk factors identified. Most repairs (76%) were performed by the Pediatric Gastroenterology division. Variability in practice was noted among services, including frequency of periprocedural antibiotic use and performance of temporary repairs before permanent repairs. A gradual increase in CVC repair rate was noted over time.
Conclusions:
Our study showed that CVC repair is effective in prolonging CVC durability in pediatric IF patients without increasing infection rates. Incorporating a temporary repair as a step before permanent repair may offer a route to address potential intraluminal thrombosis before permanent repair.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:22Aneurysm IV: Nursing Management
01:29Endocarditis IV: Nursing Management