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Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
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A Comparison of Peripherally Inserted Central Catheter Materials.

Amanda J Ullman1, Deanne August1, Tricia M Kleidon1

  • 1From the University of Queensland, Brisbane, QLD, Australia (A.J.U., D.A., T.M.K., N.M., N.R., P.L.-A., V.G., A.C., P.M., C.M.R., P.N.A.H.); Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia (A.J.U., T.M.K., P.L.-A., V.G.); Griffith University, Brisbane, QLD, Australia (A.J.U., D.A., T.M.K., R.M.W., N.M., A.C.B., R.R., J.B., V.C., C.M.R., R.S.W.); Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (A.J.U., T.M.K., N.M., K.S., A.C., P.N.A.H.); Princess Alexandra Hospital, Brisbane, QLD, Australia (R.M.W., B.P., N.R., J.L., C.B., P.M.); University of Colorado, Denver (V.C.); and Metro North Health, Brisbane, QLD, Australia (C.M.R.).

The New England Journal of Medicine
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New catheter materials, including hydrophobic and chlorhexidine peripherally inserted central catheters (PICCs), did not lower device failure risks compared to standard polyurethane PICCs in a randomized trial. Further research is needed to evaluate advanced PICC technologies.

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Area of Science:

  • Medical Devices
  • Infectious Diseases
  • Clinical Trials

Background:

  • Peripherally inserted central catheters (PICCs) are prone to failure from infections and thrombotic events.
  • Novel catheter materials aim to mitigate these complications, but robust comparative data are lacking.

Purpose of the Study:

  • To compare the efficacy of hydrophobic and chlorhexidine PICCs against standard polyurethane PICCs in reducing device failure.
  • To assess the incidence of infectious and noninfectious complications associated with different PICC materials.

Main Methods:

  • A randomized, controlled, superiority trial involving 1098 participants across three Australian hospitals.
  • Participants were assigned to receive hydrophobic, chlorhexidine, or standard polyurethane PICCs, followed for 8 weeks.
  • The primary outcome was a composite of infectious and noninfectious device failure events.

Main Results:

  • Device failure rates were 5.9% for hydrophobic, 9.9% for chlorhexidine, and 6.1% for standard polyurethane PICCs.
  • No statistically significant reduction in device failure was observed for hydrophobic or chlorhexidine PICCs versus standard polyurethane.
  • Overall complications occurred in 21.5% (hydrophobic), 38.6% (chlorhexidine), and 21.7% (standard polyurethane) of participants.

Conclusions:

  • Hydrophobic and chlorhexidine PICCs did not demonstrate a lower risk of device failure compared to standard polyurethane PICCs.
  • The study found no significant benefit of these novel materials in preventing infectious or noninfectious complications.
  • No adverse events were attributed to the investigated PICC materials.