Ryan T Hurt, Osman Mohamed Elfadil, Jithinraj Edakkanambeth Varayil, Sara L Bonnes, Bradley R Salonen, Manpreet S Mundi
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Optimizing Intravenous Access for Long-Term Parenteral Nutrition.
Purpose of review: Securing safe and effective intravenous (IV) access is of utmost importance for administering parenteral nutrition (PN). Sustaining this access can indeed pose challenges, especially when dealing with the risk of complications associated with long-term PN. This review emphasizes best practices to optimize intravenous access and reviews the current evidence-based recommendations and consensus guidelines.
Recent findings: An individualized approach when selecting central venous catheters (CVC) is recommended, considering the estimated duration of need for IV access and the number of lumens needed. Established and novel approaches to minimize complications, including infection and thrombosis, are recognized. These include placement and positioning of the catheter tip under sonographic guidance and the use of antimicrobial lock therapies. Moreover, when possible, salvaging CVCs can reduce the risk of vascular access loss. CVC selection for patients requiring PN depends on several factors. Carefully reviewing an individual patient's clinical characteristics and discussing options is important. Given the increased infection risk, CVC lumens should be minimized. For long-term PN beyond 6 months, using CVCs with skin barriers and larger diameters should be considered.
期刊介绍:
This journal aims to provide comprehensive review articles that emphasize significant developments in nutrition research emerging in recent publications. By presenting clear, insightful, balanced contributions by international experts, the journal intends to discuss the influence of nutrition on major health conditions such as diabetes, cardiovascular disease, cancer, and obesity, as well as the impact of nutrition on genetics, metabolic function, and public health. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 25 internationally diverse members reviews the annual table of contents, suggests topics of special importance to their country/region, and ensures that topics and current and include emerging research.