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Central venous catheter safety in pediatric patients with intestinal failure

Rachel Warsco Smith1,2, Melissa Pettini1, Rachel Gulden1

  • 1Division of Gastroenterology and Hepatology, Seattle Children's Hospital, Seattle, Washington, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|August 4, 2023
PubMed

Insights

Children with intestinal failure need central venous catheters for nutrition. This review details strategies to prevent and manage CVC complications, ensuring safer long-term access for these vulnerable patients.

Area of Science:

  • Pediatric Gastroenterology
  • Vascular Access Management
  • Intestinal Failure Treatment

Background:

  • Children with intestinal failure (IF) rely on long-term central venous access for parenteral nutrition.
  • Central venous catheters (CVCs) in these children are prone to mechanical, thrombotic, and infectious complications.
  • Complications can lead to catheter replacement, loss of access sites, and increased need for intestinal transplantation.

Purpose of the Study:

  • To review preventative, diagnostic, and treatment strategies for CVC safety in children with IF.
  • To provide recommendations for maintaining CVC safety during daily activities, travel, and emergencies.

Main Methods:

  • Literature review of studies on CVC complications in pediatric intestinal failure.
  • Synthesis of current evidence on CVC care, risk mitigation, and management strategies.
  • Development of practical recommendations for clinicians and caregivers.

Main Results:

  • Children with IF present unique challenges for CVC safety due to age, anatomy, and higher thrombosis/infection risk.
  • Proactive measures are crucial for preventing CVC-related morbidity.
  • Effective management protocols can minimize complications and preserve vascular access.

Conclusions:

  • Optimizing CVC safety is paramount for children with IF to improve outcomes and reduce the burden of intestinal transplantation.
  • A comprehensive approach integrating prevention, early diagnosis, and timely treatment is essential.
  • Adherence to specific safety recommendations can enhance CVC longevity and patient well-being.

Keywords:
central venous cathetersinfectionsintestinal failureparenteral nutritionpediatricssafetythrombosis

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