优化静脉输入,实现长期的亲肠道营养
Ryan T Hurt1,2,3, Osman Mohamed Elfadil4, Jithinraj Edakkanambeth Varayil5
1Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA. hurt.ryan@mayo.edu.
Current nutrition reports
|May 2, 2024
概括
优化静脉输入用于腹腔营养 (PN) 涉及精心选择中央静脉导管 (CVC) 并采用策略来最大限度地减少感染和血栓形成等并发症,确保安全的长期PN治疗.
科学领域:
- 临床营养学 临床营养学
- 血管接入 血管接入
- 医疗器械管理 医疗器械管理
背景情况:
- 亲肠道营养 (PN) 管理严重依赖于安全有效的静脉注射 (IV) 接入.
- 长期PN在维持血管通道和预防相关并发症方面存在挑战.
- 基于证据的建议和指导方针对于优化PN患者的IV接入至关重要.
研究的目的:
- 审查最佳实践,以优化在接受腹腔营养的患者的静脉输入.
- 总结目前基于证据的建议和共识指南,用于管理长期PN访问.
- 突出在PN治疗中,尽量减少与中央静脉导管 (CVC) 相关的并发症的策略.
主要方法:
- 基于证据的建议和共识指南的文献审查.
- 对既有和新的方法进行分析,以尽量减少中央静脉导管并发症.
- 讨论影响中静脉导管选择亲肠营养的因素.
主要成果:
- 建议根据需要的持续时间和所需的光量进行个性化的中央静脉导管选择.
- 导管放置和抗微生物锁治疗的超声波指导是最小化感染和血栓形成的关键.
- 挽救中央静脉导管可以减少血管接入损失.
- 由于感染风险增加,建议最大限度地减少导管光度;对于超过6个月的PN,考虑使用具有皮肤屏障和更大的直径的CVC.
结论:
- 优化静脉输入,以获得亲肠道营养需要一个个性化的方法来选择和管理中央静脉导管.
- 实施超声波指导,抗菌锁治疗和适当的导管选择等策略对于安全有效的长期PN至关重要.
- 中枢静脉导管的积极管理可以减轻风险,并改善需要亲肠道营养的患者的治疗结果.
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